A new study entitled “Outcomes of Bariatric Surgery in patients with inflammatory bowel disease” and published in Obesity Surgery, describes the safety, feasibility and efficacy of bariatric surgery in obesity patients suffering from IBD.
The consequences and complications of obesity in IBD patients are important research topics, since its prevalence in obese patients has risen in recent decades. Surgical procedures are common in the management of IBD and the difficult nature of such procedures is further complicated by obesity due to anatomical and obesity-related complications that lead to difficult post-operative recovery. Weight loss might offer a major benefit to facilitate IBD interventions, and bariatric surgery is the most effective measure to achieve weight loss and overcome obesity comorbidities. Another advantage of these surgeries is the reduction of pro-inflammatory response exacerbated by obesity. This study is important in determining the consequences these surgical procedures have in mitigating IBD in obese patients, an assessment that, according to the researchers, hasn’t been studied before.
Researchers gathered and analyzed medical data from 20 inflammatory bowel disease (IBD) patients, 13 suffering from ulcerative colitis (UC) and 7 suffering from Crohn’s disease (CD), which underwent bariatric surgery. Due to limited literature on this subject, researchers highlight that the conclusions drawn from this study are mostly from small case reports. A large number of variables were evaluated, such as body mass index (BMI), sex, age, IBD severity, type of surgery, complication events, among others. Importantly, improvement of IBD-related symptoms was also assessed.
From the sample of patients, 9 underwent sleeve gastrectomy, 7 underwent gastric bypass, gastric banding was performed on 3 patients and 1 underwent revisional procedure. Early complications derived from surgeries included dehydration (5 patients), pulmonary embolism (1 patients) and wound infection (1 patient). In a longer follow up, complications included pancreatitis (2), ventral hernia (2), and marginal ulcer (1). Six years after surgery, one of the patients died due to metastatic renal cell carcinoma. In the evaluation of improvement of IBD related symptoms, the scientists excluded cases of cure and long-term remission prior to the surgery, concluding that 9 out of the 10 eligible patients, including one UC patient that experienced acute exacerbation after surgery, experienced improvements regarding IBD gastrointestinal symptoms.
Researchers conclude that bariatric surgical procedures are indeed feasible and safe, and might be effective in alleviating IBD-related symptoms in obese patients, besides the obvious weight loss.