Editorial: de novo inflammatory bowel disease following bariatric surgery—potential implications for research and clinical practice
Abstract
The prevalence of obesity has doubled in more than 70 countries and has continuously increased in most other countries over the past 3 decades. The alarming rise in the obesity epidemic and its subsequent co-morbid conditions has led to an increase in bariatric surgery. The latter is widely considered to be the most effective treatment for severe obesity with benefits of surgery on obesity-associated complications and mortality being well established. Morbid obesity is also an emerging problem in the IBD population. Sleeve gastrectomy has previously been reported to have the dual benefit of weight loss and IBD remission. However, recent case series have linked bariatric surgery with the de novo development of IBD. The pathogenesis for this association remains speculative, with the gut microbiome being implicated. It is postulated that in the genetically predisposed individual, the altered surgical anatomy post-bypass may promote intestinal dysbiosis leading to chronic inflammation and the development of IBD. Ungaro et al have reported one of the largest case series of patients with de novo IBD following bariatric surgery. In an analysis of 8980 cases following bariatric surgery, they described 15 cases of IBD, with the majority being female patients with Crohn’s disease (CD) who underwent Roux-en-Y surgery. Similarly, a recent paper from the Mayo Clinic and Washington University reported cases of both post-bariatric CD and ulcerative colitis (UC). It is interesting to note…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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