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01-06-2018 | Original Contributions

Implications of Celiac Disease Among Patients Undergoing Gastric Bypass

Authors: Lindsey M. Freeman, Andrew T. Strong, Gautam Sharma, Suriya Punchai, John H. Rodriguez, Donald F. Kirby, Matthew Kroh

Published in: Obesity Surgery | Issue 6/2018

Abstract

Introduction

Bariatric surgery is generally safe and effective, but co-existing malabsorptive processes may increase the risk of complications or nutritional deficiencies. Bariatric surgery has not been well studied in the setting of pre-existing celiac disease.

Materials and Methods

Patients who underwent Roux-en-Y gastric bypass (RYGB) from January 2002 to December 2015 were retrospectively reviewed for either diagnosis of or serum testing for celiac disease. Identified patients were re-reviewed for adherence to American Gastroenterological Association (AGA) diagnostic criteria. Patient demographics, operative data, and post-operative weight loss and nutritional parameters were collected.

Results

Of the > 12,000 patients who underwent bariatric surgery during this study period, there were 342 patients that had abnormal serology or pathology results. Expert review confirmed three patients (0.8%) with celiac disease diagnosed before RYGB procedure. All were female, with an average age of 33 years and a mean BMI of 44.07 kg/m². At the time of surgery, two of the three patients were following a gluten-free diet. At 6 months follow-up, mean % excess weight loss was 76.5%. The patients following a gluten-free diet preoperatively continued post-operatively. No patients were anemic nor had vitamin B12 or iron deficiencies at 12-month follow-up. Two patients had vitamin D insufficiencies and responded to daily oral supplementation.

Conclusion

Though many bariatric patients may carry a presumptive diagnosis of celiac disease, a small percentage of these meet AGA diagnostic criteria. RYGB appears safe in this population with comparable weight loss in non-celiac counterparts. Increased attention to vitamin D levels may be warranted post-operatively.

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Title: Implications of Celiac Disease Among Patients Undergoing Gastric Bypass
Authors: Lindsey M. Freeman
Andrew T. Strong
Gautam Sharma
Suriya Punchai
John H. Rodriguez
Donald F. Kirby
Matthew Kroh
Publication date: 01-06-2018
Publisher: Springer US
Published in: Obesity Surgery / Issue 6/2018
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-017-3046-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Implications of Celiac Disease Among Patients Undergoing Gastric Bypass

Abstract

Introduction

Materials and Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Materials and Methods

Results

Conclusion

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