Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Obesity Surgery
Published in: Obesity Surgery 4/2018

01-04-2018 | Original Contributions

Impact of Bariatric Surgery on Outcomes of Patients with Inflammatory Bowel Disease: a Nationwide Inpatient Sample Analysis, 2004–2014

Authors: Prabin Sharma, Thomas R. McCarty, Basile Njei

Published in: Obesity Surgery | Issue 4/2018

Login to get access

Abstract

Purpose

There is a paucity of data regarding the benefits of bariatric surgery in patients with inflammatory bowel disease (IBD). The primary aim of this study was to evaluate the role of bariatric surgery on clinical outcomes among hospitalized patients with IBD.

Materials and Methods

The United States (US) National Inpatient Sample database was queried between 2004 and 2014 for discharges with co-diagnoses of morbid obesity and IBD. Hospitalizations with a history of prior-bariatric surgery were also identified. The primary outcome was in-hospital mortality. Secondary outcomes included renal failure, under-nutrition, thromboembolic events, strictures, fistulae, length of stay, and hospitalization costs. Using Poisson regression, adjusted incidence risk ratios (IRR) were derived for clinical outcomes in patients with prior-bariatric surgery compared to those without bariatric surgery.

Results

Among 15,319 patients with a discharge diagnosis of IBD and morbid obesity, 493 patients (3.2%) had bariatric surgery. From 2004 to 2014, the proportion of obese IBD patients that underwent bariatric surgery declined (5.2 versus 3.1%). In a multivariable analysis, prior-bariatric surgery was associated with decreased IRR for renal failure, under-nutrition, and fistulae formation in morbidly obese IBD patients [(IRR 0.1; 95% CI 0.02–0.3; P < 0.001), (IRR 0.2; 95% CI 0.05–0.8; P = 0.03), and (IRR 0.1; 95% 0.2–08; P = 0.03), respectively]. Bariatric surgery did not influence mortality (P = 0.99).

Conclusions

Despite a gradual increase in morbid obesity among patients with IBD, there has been a decrease in proportion of overall bariatric surgeries. Bariatric surgery appears to reduce morbidity in obese patients with IBD.
Appendix
Available only for authorised users
Literature
1.
2.
Kaplan GG. The global burden of IBD: from 2015 to 2025. Nat Rev Gastroenterol Hepatol. 2015;12:720–7.CrossRefPubMed
3.
Molodecky NA, Soon IS, Rabi DM, et al. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology. 2012;142:46–54 e42. quiz e30CrossRefPubMed
4.
Long MD, Crandall WV, Leibowitz IH, et al. Prevalence and epidemiology of overweight and obesity in children with inflammatory bowel disease. Inflamm Bowel Dis. 2011;17:2162–8.CrossRefPubMed
5.
Chan SS, Luben R, Olsen A, et al. Body mass index and the risk for Crohn’s disease and ulcerative colitis: data from a European Prospective Cohort Study (the IBD in EPIC Study). Am J Gastroenterol. 2013;108:575–82.CrossRefPubMed
6.
Mendall MA, Gunasekera AV, John BJ, et al. Is obesity a risk factor for Crohn’s disease? Dig Dis Sci. 2011;56:837–44.CrossRefPubMed
7.
Steed H, Walsh S, Reynolds N. A brief report of the epidemiology of obesity in the inflammatory bowel disease population of Tayside, Scotland. Obes Facts. 2009;2:370–2.CrossRefPubMed
8.
Moran GW, Dubeau MF, Kaplan GG, et al. The increasing weight of Crohn’s disease subjects in clinical trials: a hypothesis-generatings time-trend analysis. Inflamm Bowel Dis. 2013;19:2949–56.CrossRefPubMed
9.
Blain A, Cattan S, Beaugerie L, et al. Crohn’s disease clinical course and severity in obese patients. Clin Nutr. 2002;21:51–7.CrossRefPubMed
10.
Nic Suibhne T, Raftery TC, McMahon O, et al. High prevalence of overweight and obesity in adults with Crohn’s disease: associations with disease and lifestyle factors. J Crohns Colitis. 2013;7:e241–8.CrossRefPubMed
11.
Efron JE, Uriburu JP, Wexner SD, et al. Restorative proctocolectomy with ileal pouch anal anastomosis in obese patients. Obes Surg. 2001;11:246–51.CrossRefPubMed
12.
Benoist S, Panis Y, Alves A, et al. Impact of obesity on surgical outcomes after colorectal resection. Am J Surg. 2000;179:275–81.CrossRefPubMed
13.
Flores A, Burstein E, Cipher DJ, et al. Obesity in inflammatory bowel disease: a marker of less severe disease. Dig Dis Sci. 2015;60:2436–45.CrossRefPubMed
14.
Santry HP, Gillen DL, Lauderdale DS. Trends in bariatric surgical procedures. JAMA. 2005;294:1909–17.CrossRefPubMed
15.
Romero-Talamas H, Daigle CR, Aminian A, et al. The effect of bariatric surgery on gout: a comparative study. Surg Obes Relat Dis. 2014;10:1161–5.CrossRefPubMed
16.
Romero-Talamas H, Aminian A, Corcelles R, et al. Psoriasis improvement after bariatric surgery. Surg Obes Relat Dis. 2014;10:1155–9.CrossRefPubMed
17.
Corcelles R, Daigle CR, Talamas HR, et al. Bariatric surgery outcomes in patients with systemic lupus erythematosus. Surg Obes Relat Dis. 2015;11:684–8.CrossRefPubMed
18.
Hass DJ, Brensinger CM, Lewis JD, et al. The impact of increased body mass index on the clinical course of Crohn’s disease. Clin Gastroenterol Hepatol. 2006;4:482–8.CrossRefPubMed
19.
Keidar A, Hazan D, Sadot E, et al. The role of bariatric surgery in morbidly obese patients with inflammatory bowel disease. Surg Obes Relat Dis. 2015;11:132–6.CrossRefPubMed
20.
Navaneethan U, Parasa S, Venkatesh PG, et al. Impact of inflammatory bowel disease on post-cholecystectomy complications and hospitalization costs: a Nationwide Inpatient Sample study. J Crohns Colitis. 2013;7:e164–70.CrossRefPubMed
21.
22.
Krane MK, Allaix ME, Zoccali M, et al. Does morbid obesity change outcomes after laparoscopic surgery for inflammatory bowel disease? Review of 626 consecutive cases. J Am Coll Surg. 2013;216:986–96.CrossRefPubMed
23.
24.
25.
Anderson RN, Rosenberg HM. Age standardization of death rates: implementation of the year 2000 standard. National vital statistics report: from the Centers for Disease Control and Prevention, National Center for Health Statistics. Natl Vital Stat Syst. 1998;47:1–16, 20.
26.
Karmiris K, Koutroubakis IE, Xidakis C, et al. Circulating levels of leptin, adiponectin, resistin, and ghrelin in inflammatory bowel disease. Inflamm Bowel Dis. 2006;12:100–5.CrossRefPubMed
27.
Yamamoto K, Kiyohara T, Murayama Y, et al. Production of adiponectin, an anti-inflammatory protein, in mesenteric adipose tissue in Crohn’s disease. Gut. 2005;54:789–96.CrossRefPubMedPubMedCentral
28.
Valentini L, Wirth EK, Schweizer U, et al. Circulating adipokines and the protective effects of hyperinsulinemia in inflammatory bowel disease. Nutrition. 2009;25:172–81.CrossRefPubMed
29.
Versini M, Jeandel PY, Rosenthal E, et al. Obesity in autoimmune diseases: not a passive bystander. Autoimmun Rev. 2014;13:981–1000.CrossRefPubMed
30.
Yamamoto T, Shiraki M. Prevalence of overweight and obesity in patients with Crohn’s disease in Western countries and Japan. J Crohns Colitis. 2013;7:e192.CrossRefPubMed
31.
Colombo F, Rizzi A, Ferrari C, et al. Bariatric surgery in patients with inflammatory bowel disease: an accessible path? Report of a case series and review of the literature. J Crohns Colitis. 2015;9:185–90.CrossRefPubMed
32.
Causey MW, Johnson EK, Miller S, et al. The impact of obesity on outcomes following major surgery for Crohn’s disease: an American College of Surgeons National Surgical Quality Improvement Program assessment. Dis Colon rectum. 2011;54:1488–95.CrossRefPubMed
33.
Ahn LB, Huang CS, Forse RA, et al. Crohn’s disease after gastric bypass surgery for morbid obesity: is there an association? Inflamm Bowel Dis. 2005;11:622–4.CrossRefPubMed
34.
Dodell GB, Albu JB, Attia L, et al. The bariatric surgery patient: lost to follow-up; from morbid obesity to severe malnutrition. Endocr Pract. 2012;18:e21–5.CrossRefPubMedPubMedCentral
35.
36.
Nascimento AT, Rocha R, Coqueiro FG, et al. Does obesity complicate inflammatory bowel diseases? J Crohns Colitis. 2012;6:1041.CrossRefPubMed
37.
Aminian A, Andalib A, Ver MR, et al. Outcomes of bariatric surgery in patients with inflammatory bowel disease. Obes Surg. 2016;26:1186–90.CrossRefPubMed
38.
Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2013. Obes Surg. 2015;25:1822–32.CrossRefPubMed
39.
40.
41.
Fischer L, Hildebrandt C, Bruckner T, et al. Excessive weight loss after sleeve gastrectomy: a systematic review. Obes Surg. 2012;22:721–31.CrossRefPubMed
42.
Khan S, Rock K, Baskara A, et al. Trends in bariatric surgery from 2008 to 2012. Am J Surg. 2016;211:1041–6.CrossRefPubMed
43.
Shoar S, Shahabuddin Hoseini S, Naderan M, et al. Bariatric surgery in morbidly obese patients with inflammatory bowel disease: a systematic review. Surg Obes Relat Dis. 2017;13:652–9.CrossRefPubMed
44.
Lieske JC, Mehta RA, Milliner DS, et al. Kidney stones are common after bariatric surgery. Kidney Int. 2015;87:839–45.CrossRefPubMed
45.
46.
Seghieri M, Vitolo E, Giannini L, et al. Determinants of glomerular filtration rate following bariatric surgery in individuals with severe, otherwise uncomplicated, obesity: an observational, prospective study. Acta Diabetol. 2017;54:593–8.CrossRefPubMed
47.
48.
Barnes EL, Beery RM, Schulman AR, et al. Hospitalizations for acute myocardial infarction are decreased among patients with inflammatory bowel disease using a nationwide inpatient database. Inflamm Bowel Dis. 2016;22:2229–37.CrossRefPubMed
Metadata
Title
Impact of Bariatric Surgery on Outcomes of Patients with Inflammatory Bowel Disease: a Nationwide Inpatient Sample Analysis, 2004–2014
Authors
Prabin Sharma
Thomas R. McCarty
Basile Njei
Publication date
01-04-2018
Publisher
Springer US
Published in
Obesity Surgery / Issue 4/2018
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-017-2959-0

Other articles of this Issue 4/2018

Obesity Surgery 4/2018 Go to the issue

Original Contributions

Risk of Metformin-Associated Lactic Acidosis (MALA) in Patients After Gastric Bypass Surgery

Biography

Miguel-Angel Carbajo, MD, PhD

Original Contributions

Revisional Gastric Bypass for Failed Restrictive Procedures: Comparison of Single-Anastomosis (Mini-) and Roux-en-Y Gastric Bypass

Letter to the Editor

Reply to: “Patients’ Expectations Are Important for Success in Bariatric Surgery”

Original Contributions

Surgical Management of Gastrogastric Fistula After Roux-en-Y Gastric Bypass: 10-Year Experience

Original Contributions

Bariatric Surgery Is Acceptably Safe in Obese Inflammatory Bowel Disease Patients: Analysis of the Nationwide Inpatient Sample