Severe Malnutrition and Celiac Disease Following Gastric by-Pass Surgery

Marini, Juan M.; Coghlan, Eduardo; Laferrere, Luis; Zenon, María Elisa; Román, Alberto San; Nadales, Ángel

doi:10.5171/2014.130992

Cited by 2 publications

(6 citation statements)

References 12 publications

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“…Four case reports 10-12,16 outlined patients experiencing either nausea, vomiting, diarrhea, and, in 1 instance, 10 mental status fluctuations and eventual death following bariatric surgery (Table 2). In all cases, post-operative biopsies demonstrated jejunal villous atrophy and crypt hyperplasia, and a diagnosis of CD 11,12,16 or subclinical CD 10 were made. Marini et al, 11 Owen et al, 12 and Pané et al 16 reported symptom alleviation following implementation of a GFD.…”

Section: Resultsmentioning

confidence: 99%

“…Full-text review further excluded 7 studies; reasons for exclusion can be found in Figure 1. A total of 9 studies 9-17 were deemed acceptable for the present review, these included: 1 retrospective case series, 1 case series, 5 case reports, and 2 retrospective cohort study (Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…The 9 studies reported a total of 152 patients who underwent bariatric surgery for obesity management and had a diagnosis of CD (Table 1). 9-17 The weighted mean age at time of surgery was 44.2 years (±9.55 years) and 98% of reported patients were female. Reported patient co-morbidities are found in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…In all cases, post-operative biopsies demonstrated jejunal villous atrophy and crypt hyperplasia, and a diagnosis of CD 11,12,16 or subclinical CD 10 were made. Marini et al, 11 Owen et al, 12 and Pané et al 16 reported symptom alleviation following implementation of a GFD. Logan and Ferguson 10 initiated a non-strict GFD and eventual reversal of the jejunoileal bypass; the patient died shortly after these measures.…”

Section: Resultsmentioning

confidence: 99%

“…In patients with a post-operative CD diagnosis, persistent diarrhea, vomiting, malodorous stools, clinically severe weight loss, abdominal pain, and hospitalization occurred. [10][11][12]16 Although these patients returned to near or fully asymptomatic levels following their post-operative diagnosis and introduction of a GFD, they experienced a myriad of additional symptoms than those with a pre-operative CD diagnosis. Comparatively, patients with pre-operative CD diagnoses appeared to have unremarkable post-operative courses following either RYGB or SG.…”

Section: Discussionmentioning

confidence: 99%

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Celiac Disease and Bariatric Surgery: A Systematic Review of Current Literature

Richard

Mocanu

Verhoeff

et al. 2022

Foregut: The Journal of the American Foregut Society

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Background: Celiac disease (CD) is a clinical entity increasingly recognized in the severe obese population and its impact on outcomes following bariatric surgery is not currently understood. We aimed to systematically review the nutritional and clinical outcomes for patients with obesity and CD following bariatric surgery. Methods: Systematic search of MEDLINE, Embase, Scopus, and Web of Science was conducted in September 2021. Study followed PRISMA guidelines. Studies evaluating adult patients with CD undergoing bariatric surgery were included. Outcomes were descriptive due to limited studies. Results: Our literature review produced 9 studies with 152 patients. The weighted mean age of included patients was 44.2 years (±9.55 years) and 98% (n = 149) were female. Patients diagnosed with CD post-operatively appear to experience substantial perioperative and nutritional complications following bariatric surgery. However, pre-operative diagnosis may allow patient optimization and current studies suggest similar bariatric surgery outcomes can be achieved in these patients when the diagnosis is known. However, this study also highlights a scarcity of evidence evaluating the rate of CD and outcomes for these patients after bariatric surgery. Conclusion: Current literature lacks quality, comparative studies investigating the short- and long-term surgical complications and nutritional outcomes of bariatric surgery within patients who have co-diagnoses of obesity and CD. Despite these limitations, our group recommends pre-operative CD screening in patients experiencing either classical GI symptoms of CD including diarrhea, steatorrhea, bloating, or undifferentiated abdominal pain.

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