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

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

Research output: Contribution to journalArticle

7 Citations (Scopus)

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 (US)
Pages (from-to)452-457
Number of pages6
JournalJournal of Crohn's and Colitis
Volume12
Issue number4
DOIs
StatePublished - Apr 1 2018

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Bariatric Surgery
Inflammatory Bowel Diseases
Crohn Disease
Ulcerative Colitis
Incidence
Age Groups
Databases
Gastric Bypass
Electronic Health Records
Causality
Demography
Phenotype

Keywords

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

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Neto, M. B. B., Gregory, M., Ramos, G. P., Loftus, Jr, E. V., Ciorba, M. A., Bruining, D. H., ... 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

De-novo inflammatory bowel disease after bariatric surgery : A large case series. / Neto, Manuel B.Braga; Gregory, Martin; Ramos, Guilherme P.; Loftus, Jr, Edward Vincent; Ciorba, Matthew A.; Bruining, David H; Bazerbachi, Fateh; Abu Dayyeh, Barham K.; Kushnir, Vladimir M.; Shah, Meera; Collazo-Clavell, Maria L.; Raffals, Laura E. H.; Deepak, Parakkal.

In: Journal of Crohn's and Colitis, Vol. 12, No. 4, 01.04.2018, p. 452-457.

Research output: Contribution to journalArticle

Neto, MBB, Gregory, M, Ramos, GP, Loftus, Jr, EV, Ciorba, MA, Bruining, DH, Bazerbachi, F, Abu Dayyeh, BK, Kushnir, VM, Shah, M, Collazo-Clavell, ML, Raffals, LEH & Deepak, P 2018, 'De-novo inflammatory bowel disease after bariatric surgery: A large case series', Journal of Crohn's and Colitis, vol. 12, no. 4, pp. 452-457. https://doi.org/10.1093/ecco-jcc/jjx177
Neto, Manuel B.Braga ; Gregory, Martin ; Ramos, Guilherme P. ; Loftus, Jr, Edward Vincent ; Ciorba, Matthew A. ; Bruining, David H ; Bazerbachi, Fateh ; Abu Dayyeh, Barham K. ; Kushnir, Vladimir M. ; Shah, Meera ; Collazo-Clavell, Maria L. ; Raffals, Laura E. H. ; Deepak, Parakkal. / De-novo inflammatory bowel disease after bariatric surgery : A large case series. In: Journal of Crohn's and Colitis. 2018 ; Vol. 12, No. 4. pp. 452-457.
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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.",
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AU - Bazerbachi, Fateh

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