Safety of bariatric surgery in patients with inflammatory bowel disease: A systematic review and meta-analysis.
ulcerative colitis; bariatric surgery; inflammatory bowel disease; Crohn's disease
The efficacy of bariatric surgery in achieving weight loss and preventing long-term comorbidities such as cardiovascular diseases, diabetes mellitus and osteoarthritis is well established. Data regarding safety of bariatric surgery in patients with inflammatory bowel disease (IBD) is scarce. We attempted a systematic review and meta-analysis to evaluate the complications following bariatric surgery in patients with IBD. The primary outcomes evaluated were wound infection, Clavien-Dindo grade > II complications and IBD exacerbation (within 1 year). Secondary outcomes evaluated included overall mortality, stricture, small bowel obstruction, acute kidney injury (AKI) and thromboembolism. Pooled outcomes (event rate) with 95% confidence interval (CI) were calculated using random effects model. A total of 14 studies (all observational) with 2608 patients were included. The rates of primary outcomes were: wound infection (4.1%, 95% CI: 0.9-7.2), Clavien-Dindo grade > II complications (2.0%, 95%: CI 0.6-3.5) and IBD exacerbation (4.3%, 95% CI: 0.7-7.9). The pooled rate for other outcomes was: mortality 0.1%, stricture 6.5%, small bowel obstruction 6.7%, AKI 2.2% and thromboembolism 0.1%. Bariatric surgery is relatively safe in patients with IBD and should be pursued to reduce comorbidities associated with obesity. Future comparative studies are needed to further assess the safety of bariatric surgery in population with and without IBD.
Aziz M; Haghbin H; Sharma S; Fatima R; Ishtiaq R; Chandan S; Mohan BP; Lee-Smith W; Hassan M; Nawras A
Clinical Obesity
2020
2020-09-02
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journalArticle
<a href="http://doi.org/10.1111/cob.12405" target="_blank" rel="noreferrer noopener">10.1111/cob.12405</a>
Bile Synthesis In Rat Models Of Inflammatory Bowel Diseases
acid synthesis; acute-phase response; acute-phase response; bile synthesis; cholesterol 7-alpha hydroxylase; cholesterol 7-alpha-hydroxylase gene; colitis; crohns-disease; experimental; General & Internal Medicine; inflammatory bowel disease; intestinal inflammation; messenger-rna; nitric-oxide; Research & Experimental Medicine; sulfonic-acid; ulcerative-colitis
Dikopoulos N; Schmid R M; Bachem M; Buttenschoen K; Adler G; Chiang J Y L; Weidenbach H
European Journal of Clinical Investigation
2007
2007-03
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1111/j.1365-2362.2007.01779.x" target="_blank" rel="noreferrer noopener">10.1111/j.1365-2362.2007.01779.x</a>
SEROLOGIC REACTIVITY AGAINST MYCOBACTERIUM-PARATUBERCULOSIS ANTIGENS IN PATIENTS WITH SARCOIDOSIS
antibodies; crohns-disease; crohns-disease; elisa; elisa assay; inflammatory bowel disease; linked immunosorbent-assay; mycobacterium-paratuberculosis; Respiratory System; tuberculosis
Although sarcoidosis has clinical and histopathologic similarities to some forms of tuberculosis and other mycobacterial infections, attempts to establish a mycobacterial etiology have not been successful. Using cytoplasmic antigens derived from a wild strain of Mycobacterium paratuberculosis in an enzyme-linked immunosorbent assay, patients with sarcoidosis were found to have immunoglobulin levels significantly higher than those found in a control population in the IgG, but not in IgA or IgM antibody classes. Results were comparable to those reported from patients with Crohn's disease, where M. paratuberculosis has been intensively studied as a possible etiologic agent. To elucidate these relationships, examination of DNA from sarcoid tissues for possible homology with DNA from M. paratuberculosis and closely related organisms, as well as cultural attempts with techniques and media appropriate for M. paratuberculosis may be warranted.
Reid J D; Chiodini R J
Sarcoidosis
1993
1993-03
Journal Article
n/a
Reduced Paneth cell alpha-defensins in ileal Crohn's disease
bacteria; expression; gene; human intestinal defensin; inflammatory bowel disease; inflammatory bowel disease; innate; innate immunity; intestine; mechanisms; microflora; mutations; peptides; Science & Technology - Other Topics
The pathogenesis of Crohn's disease (CD), an idiopathic inflammatory bowel disease, is attributed, in part, to intestinal bacteria that may initiate and perpetuate mucosal inflammation in genetically susceptible individuals. Paneth cells (PC) are the major source of antimicrobial peptides in the small intestine, including human alpha-defensins HD5 and HD6. We tested the hypothesis that reduced expression of PC alpha-defensins compromises mucosal host defenses and predisposes patients to CD of the ileum. We report that patients with CID of the ileum have reduced antibacterial activity in their intestinal mucosal extracts. These specimens also showed decreased expression of PC alpha-defensins, whereas the expression of eight other PC products either remained unchanged or increased when compared with controls. The specific decrease of alpha-defensins was independent of the degree of inflammation in the specimens and was not observed in either CD of the colon, ulcerative colitis, or pouchitis. The functional consequence of alpha-defensin expression levels was examined by using a transgenic mouse model, where we found changes in HD5 expression levels, comparable to those observed in CD, had a pronounced impact on the luminal microbiota. Thus, the specific deficiency of PC defensins that characterizes ileal CD may compromise innate immune defenses of the ileal mucosa and initiate and/or perpetuate this disease.
Wehkamp J; Salzman N H; Porter E; Nuding S; Weichenthal M; Petras R E; Shen B; Schaeffeler E; Schwab M; Linzmeier R; Feathers R W; Chu H T; Lima H; Fellermann K; Ganz T; Stange E F; Bevins C L
Proceedings of the National Academy of Sciences of the United States of America
2005
2005-12
Journal Article
<a href="http://doi.org/10.1073/pnas.0505256102" target="_blank" rel="noreferrer noopener">10.1073/pnas.0505256102</a>