@article{6ba55ee081134d3b8021518fe1a7bbff,
title = "Impact of Bariatric Surgery on the Long-term Disease Course of Inflammatory Bowel Disease",
abstract = "An association between inflammatory bowel disease (IBD) and obesity has been observed. Little is known about the effect of weight loss on IBD course. Our aim was to determine the impact of bariatric surgery on long-term clinical course of obese patients with IBD, either Crohn's disease (CD) or ulcerative colitis (UC). Methods: Patients with IBD who underwent bariatric surgery subsequent to IBD diagnosis were identified from 2 tertiary IBD centers. Complications after bariatric surgery were recorded. Patients were matched 1:1 for age, sex, IBD subtype, phenotype, and location to patients with IBD who did not undergo bariatric surgery. Controls started follow-up at a time point in their disease similar to the disease duration in the matched case at the time of bariatric surgery. Inflammatory bowel disease medication usage and disease-related complications (need for corticosteroids, hospitalizations, and surgeries) among cases and controls were compared. Results: Forty-seven patients met inclusion criteria. Appropriate matches were found for 25 cases. Median follow-up among cases (after bariatric surgery) and controls was 7.69 and 7.89 years, respectively. Median decrease in body mass index after bariatric surgery was 12.2. Rescue corticosteroid usage and IBD-related surgeries were numerically less common in cases than controls (24% vs 52%; odds ratio [OR], 0.36; 95% confidence interval [CI], 0.08-1.23; 12% vs 28%; OR, 0.2; 95% CI, 0.004-1.79). Two cases and 1 control were able to discontinue biologics during follow-up. Conclusions: Inflammatory bowel disease patients with weight loss after bariatric surgery had fewer IBD-related complications compared with matched controls. This observation requires validation in a prospective study design.",
keywords = "Bariatric surgery, Crohn's disease, obesity, ulcerative colitis",
author = "{Braga Neto}, {Manuel B.} and Gregory, {Martin H.} and Ramos, {Guilherme P.} and Fateh Bazerbachi and Bruining, {David H.} and {Abu Dayyeh}, {Barham K.} and Kushnir, {Vladimir M.} and Raffals, {Laura E.} and Ciorba, {Matthew A.} and Loftus, {Edward V.} and Parakkal Deepak",
note = "Funding Information: Received for publications July 20, 2019; Editorial Decision September 9, 2019. From the *Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA; †Division of Gastroenterology, John T. Milliken Department of Medicine, Washington University School of Medicine, Saint Louis, Missouri, USA; ‡Washington University Inflammatory Bowel Diseases Center, Saint Louis, Missouri, USA aEqual contribution Supported by: P.D. is supported by a Junior Faculty Development Award from the American College of Gastroenterology. M.A.C. is supported by DK109384, a Crohn's and Colitis Foundation Daniel H. Present Senior Research Award (Ref. 370763), and philanthropic support from the Givin' it all for Guts Foundation (https:// givinitallforguts.org) and the Lawrence C. Pakula MD IBD Research Innovation and Education Fund. The work performed in this paper was additionally supported by grants provided by the National Institutes of Health through the Washington University in Saint Louis' Digestive Disease Research Core (P30 DK052574). Funding Information: Edward V. Loftus Jr.: consulting for AbbVie, Allergan, Amgen, Bristol-Myers Squibb, Celgene, Celltrion, Eli Lilly, Janssen, Pfizer, Takeda, UCB; research support from AbbVie, Amgen, Celgene, Genentech, Gilead, Janssen, Medimmune, Pfizer, Robarts Clinical Trials, Seres, Takeda, UCB. Matthew A. Ciorba: speakers' bureau or consulting for AbbVie, Pfizer, Takeda, UCB; grants from Incyte, no relation to this work. Parakkal Deepak: speakers' bureau for Abbvie; advisory board for Pfizer and Janssen; research grant from Takeda. Publisher Copyright: {\textcopyright} 2019 Crohn's & Colitis Foundation. Published by Oxford University Press. All rights reserved.",
year = "2020",
month = jun,
day = "18",
doi = "10.1093/ibd/izz236",
language = "English (US)",
volume = "26",
pages = "1089--1097",
journal = "Inflammatory Bowel Diseases",
issn = "1078-0998",
publisher = "John Wiley and Sons Inc.",
number = "7",
}