Weight-Loss Surgery Works in IBD Patients
June 30, 2012
Obese patients with inflammatory bowel disease (IBD) had weight loss and resolution of other obesity-related complications, similar to that of patients without IBD, after bariatric surgery, a small retrospective study showed.
Weight loss varied substantially by the type of bariatric procedure used, ranging from 26% of excess weight with adjustable banding to 95% with sleeve gastrectomy. The 17 patients in the study had a variety of obesity-related health problems, and all 17 had resolution or improvement in the conditions, including diabetes, hypertension, sleep apnea, hyperlipidemia, and gastroesophageal reflux disease (GERD).
“These patients have done really well,” Daniel Gagné, MD, of West Penn Allegheny Health System in Pittsburgh, told MedPage Today. “With the exception of three Crohn’s patients who had postoperative complications, the patients have had no problems.”
Follow-up is pretty much the same as with other patients without IBD. They are on the same nutrition regimen. We follow them regularly and check their lab results, which are usually normal,” he explained.
Crohn’s disease and ulcerative colitis has been considered a relative contraindication to bariatric surgery. Published case reports have offered conflicting information about the effect of bariatric surgery on these IBDs. Some have suggested the surgery exacerbates IBD symptoms, and others have provided evidence that surgery-induced weight loss reduces systemic inflammation, leading to better symptom control and reduced medication use.
To add to the knowledge base, Gagne and colleagues retrospectively reviewed outcomes of 3,002 patients who underwent bariatric surgery from July 1999 to May 2012. The records included 13 of 17 patients who had a history of IBD: eight with ulcerative colitis and nine with Crohn’s disease.