Does Gastric Surgery (Such as Bariatric Surgery) Impact the Risk of Intestinal Inflammation?

Background: The prevalence of morbid obesity and inflammatory bowel disease (IBD) is on the rise in association with a Western lifestyle. Both conditions are characterized by chronic inflammation. Bariatric surgery (BS) is a recommended and widely used approach to address severe obesity and its related comorbidities. Roux-en-Y gastric bypass (RYGBP) and sleeve gastrectomy (SG) are the most frequently performed procedures worldwide. Evidence is scarce on outcomes of BS in IBD patients. Summary: Systemic and adipose-tissue inflammation seems to decrease following BS. Different studies observed decreased serum levels of inflammatory markers (CRP, IL-6, MCP-1, and TNF-α) along with a reduction of insulin resistance both after RYGBP and SG. Several authors documented postbariatric improvement of concomitant chronic inflammatory diseases (rheumatoid arthritis, systemic lupus erythematosus, gout, and psoriasis). There are only few retrospective case series on outcomes of BS in IBD patients. These studies reported safety and feasibility of BS and improvement in IBD status, manifested by prolonged disease remission and decreased use of pharmacotherapy. Weight loss outcomes were excellent and similar to those of Received: August 17, 2016 Accepted: August 21, 2016 Published online: September 15, 2016 Prof. Dr. med. Marco Bueter, PhD Department of Visceral and Transplant Surgery, University Hospital Zurich Rämistrasse 100 CH–8091 Zurich (Switzerland) E-Mail marco.bueter @ usz.ch © 2016 S. Karger AG, Basel 2296–9403/16/0013–0129$39.50/0