De-novo inflammatory bowel disease after bariatric surgery: A large case series

Manuel B.Braga Neto, Martin Gregory, Guilherme P. Ramos, Edward V. Loftus, Matthew A. Ciorba, David H. Bruining, Fateh Bazerbachi, Barham K. Abu Dayyeh, Vladimir M. Kushnir, Meera Shah, Maria L. Collazo-Clavell, Laura E. Raffals, Parakkal Deepak

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11 Scopus citations

Abstract

Background: Case reports of inflammatory bowel diseases [IBD] have been reported in patients with a history of bariatric surgery. Our aim was to characterize patients who were diagnosed with IBD after having undergone bariatric surgery. Methods: Electronic medical records were reviewed at two institutions to identify patients who developed de-novo Crohn's disease or ulcerative colitis [UC] after bariatric surgery. Data on demographics, type of bariatric surgical procedure, IBD subtype, phenotype and medication usage were obtained. The incidence rate of de-novo IBD after bariatric surgery [per 100 000 personyears] and standardized incidence ratio [SIR] were estimated from a prospective bariatric surgery database. Results: A total of 44 patients with de-novo IBD after bariatric surgery were identified [31 Crohn's disease, 12 UC, one IBD unclassified]. Most patients were female [88.6%], with median age at IBD onset of 44 years [IQR, 37-52] and median time to IBD diagnosis after bariatric surgery of 7 years [IQR, 3-10]. Sixty-eight per cent underwent Roux-en-Y gastric bypass. In the prospective database, the incidence of IBD in patients who underwent bariatric surgery was 26.7 per 100 000 person-years [4.5 for UC and 22.3 for Crohn's disease]. The age-adjusted SIR ranged from 3.56 in the 40-49 year age group to 4.73 in the 30-39 year age group. Conclusion: We described a case series of patients developing de-novo IBD after bariatric surgery. There appears to be a numerically higher incidence of Crohn's disease in this population. Confirmation of causality is required in larger patient cohorts.

Original languageEnglish
Pages (from-to)452-457
Number of pages6
JournalJournal of Crohn's and Colitis
Volume12
Issue number4
DOIs
StatePublished - Apr 2018

Keywords

  • Bariatric surgery
  • Crohn's disease
  • Obesity
  • Ulcerative colitis

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    Neto, M. B. B., Gregory, M., Ramos, G. P., Loftus, E. V., Ciorba, M. A., Bruining, D. H., Bazerbachi, F., Abu Dayyeh, B. K., Kushnir, V. M., Shah, M., Collazo-Clavell, M. L., Raffals, L. E., & Deepak, P. (2018). De-novo inflammatory bowel disease after bariatric surgery: A large case series. Journal of Crohn's and Colitis, 12(4), 452-457. https://doi.org/10.1093/ecco-jcc/jjx177