scholarly journals Impact of Bariatric Surgery on the Long-term Disease Course of Inflammatory Bowel Disease

2019 ◽  
Vol 26 (7) ◽  
pp. 1089-1097 ◽  
Author(s):  
Manuel B Braga Neto ◽  
Martin H Gregory ◽  
Guilherme P Ramos ◽  
Fateh Bazerbachi ◽  
David H Bruining ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Inflammatory Bowel Disease ◽  
Weight Loss ◽  
Bowel Disease ◽  
Inflammatory Bowel ◽  
A Prospective Study ◽  
Prospective Study Design ◽  
The Impact

Abstract Background An association between inflammatory bowel disease (IBD) and obesity has been observed. Little is known about the effect of weight loss on IBD course. Our aim was to determine the impact of bariatric surgery on long-term clinical course of obese patients with IBD, either Crohn's disease (CD) or ulcerative colitis (UC). Methods Patients with IBD who underwent bariatric surgery subsequent to IBD diagnosis were identified from 2 tertiary IBD centers. Complications after bariatric surgery were recorded. Patients were matched 1:1 for age, sex, IBD subtype, phenotype, and location to patients with IBD who did not undergo bariatric surgery. Controls started follow-up at a time point in their disease similar to the disease duration in the matched case at the time of bariatric surgery. Inflammatory bowel disease medication usage and disease-related complications (need for corticosteroids, hospitalizations, and surgeries) among cases and controls were compared. Results Forty-seven patients met inclusion criteria. Appropriate matches were found for 25 cases. Median follow-up among cases (after bariatric surgery) and controls was 7.69 and 7.89 years, respectively. Median decrease in body mass index after bariatric surgery was 12.2. Rescue corticosteroid usage and IBD-related surgeries were numerically less common in cases than controls (24% vs 52%; odds ratio [OR], 0.36; 95% confidence interval [CI], 0.08–1.23; 12% vs 28%; OR, 0.2; 95% CI, 0.004–1.79). Two cases and 1 control were able to discontinue biologics during follow-up. Conclusions Inflammatory bowel disease patients with weight loss after bariatric surgery had fewer IBD-related complications compared with matched controls. This observation requires validation in a prospective study design.

Risk of de-novo inflammatory bowel disease among obese patients treated with bariatric surgery or weight loss medications

2020 ◽  
Vol 51 (11) ◽  
pp. 1067-1075 ◽  
Author(s):  
Gursimran S. Kochhar ◽  
Aakash Desai ◽  
Aslam Syed ◽  
Abhinav Grover ◽  
Sandra El Hachem ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Inflammatory Bowel Disease ◽  
Weight Loss ◽  
Bowel Disease ◽  
De Novo ◽  
Obese Patients ◽  
Inflammatory Bowel ◽  
Weight Loss Medications

scholarly journals P778 Longitudinal trajectory of fatigue in inflammatory bowel disease patients: a prospective study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S616-S617
Author(s):  
N Borren ◽  
M Long ◽  
J van der Woude ◽  
R Sandler ◽  
A Ananthakrishnan
Keyword(s):  
Inflammatory Bowel Disease ◽  
Prospective Study ◽  
Sleep Disturbance ◽  
Bowel Disease ◽  
Substantial Impact ◽  
Persistent Fatigue ◽  
Inflammatory Bowel ◽  
A Prospective Study ◽  
Time Point

Abstract Background Fatigue is a commonly reported and sometimes disabling symptom in patients with inflammatory bowel disease (IBD). Its prevalence, mechanism, and impact remain poorly understood. Using a large cohort of patients with IBD, we aimed to prospectively determine the trajectory of fatigue and to identify determinants and impact of incident and prevalent fatigue on patients with IBD. Methods This prospective study was nested within the IBD partners cohort, a validated internet-based cohort of patients with IBD. Participants were invited to prospectively complete questionnaires assessing fatigue status at baseline and subsequently after 6 and 12 months. Fatigue was assessed using the validated Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) score. A FACIT-F score of < 43 was defined as significant fatigue. We examined the trajectory and predictors of different courses of fatigue including incident fatigue (not fatigued as baseline but fatigued at 6 months) and resolved fatigue (fatigue at baseline but resolved on follow-up). Results A total of 2429 patients (1605 CD, 824 UC) completed baseline assessment among whom 1057 completed a second assessment at 6 months. First, we identified three distinct patterns of fatigue. Episodic fatigue defined as fatigue at any one (but not both) time point was the most common, affecting 1182 patients (57.0%). Persistent fatigue (at both baseline and follow-up) affected 33.5% (n = 695) while only 196 patients (9.5%) reported no fatigue at any time point (n = 196) (Figure). Patients that reported persistent or intermittent fatigue were more likely to have active disease (p < 0.001), be younger, (p < 0.001), report anaemia (p = 0.002) and low vitamin B12 levels (p < 0.001) and to have a prior diagnosis of depression, anxiety or sleep disorder (p < 0.001). Among patients who were not fatigued at baseline, 26% developed new fatigue at 6 months defined as incident fatigue). The strongest predictor of this being presence of sleep disturbance at baseline (OR 2.45, 95% CI 0.24–1.55) (Table). In contrast, only 12.3% of those with fatigue at baseline had symptom resolution by month 6. Resolution of fatigue was more common in those with UC (p = 0.03), quiescent disease at baseline (p = 0.006), not receiving biologic therapy at baseline (p = 0.016) and no sleep disturbance (p < 0.001), anxiety (p = 0.002) and depressive (p = 0.005) symptoms at baseline. Conclusion Our findings indicate three distinct trajectories of fatigue in patients with IBD with their distinct predictors. Importantly, 26% of patients developed new onset fatigue at 6 months demonstrating the substantial impact of this on patients with IBD.

Activity of Inflammatory Bowel Disease After Liver Transplantation for Primary Sclerosing Cholangitis Predicts Poorer Clinical Outcomes

2020 ◽  
Vol 26 (12) ◽  
pp. 1901-1908 ◽  
Author(s):  
Matthew Peverelle ◽  
Sarang Paleri ◽  
Jed Hughes ◽  
Peter De Cruz ◽  
Paul J Gow
Keyword(s):  
Colorectal Cancer ◽  
Inflammatory Bowel Disease ◽  
Liver Transplantation ◽  
Bowel Disease ◽  
Sclerosing Cholangitis ◽  
High Grade ◽  
Long Term Outcomes ◽  
Inflammatory Bowel ◽  
The Impact

Abstract Background The impact of inflammatory bowel disease (IBD) activity on long-term outcomes after liver transplantation (LT) for primary sclerosing cholangitis (PSC) is unknown. We examined the impact of post-LT IBD activity on clinically significant outcomes. Methods One hundred twelve patients undergoing LT for PSC from 2 centers were studied for a median of 7 years. Patients were divided into 3 groups according to their IBD activity after LT: no IBD, mild IBD, and moderate to severe IBD. Patients were classified as having moderate to severe IBD if they met at least 1 of 3 criteria: (i) Mayo 2 or 3 colitis or Simple Endoscopic Score–Crohn’s Disease ≥7 on endoscopy; (ii) acute flare of IBD necessitating steroid rescue therapy; or (iii) post-LT colectomy for medically refractory IBD. Results Moderate to severe IBD at any time post-transplant was associated with a higher risk of Clostridium difficile infection (27% vs 8% mild IBD vs 8% no IBD; P = 0.02), colorectal cancer/high-grade dysplasia (21% vs 3% both groups; P = 0.004), post-LT colectomy (33% vs 3% vs 0%) and rPSC (64% vs 18% vs 20%; P < 0.001). Multivariate analysis revealed that moderate to severe IBD increased the risk of both rPSC (relative risk [RR], 8.80; 95% confidence interval [CI], 2.81–27.59; P < 0.001) and colorectal cancer/high-grade dysplasia (RR, 10.45; 95% CI, 3.55–22.74; P < 0.001). Conclusions Moderate to severe IBD at any time post-LT is associated with a higher risk of rPSC and colorectal neoplasia compared with mild IBD and no IBD. Patients with no IBD and mild IBD have similar post-LT outcomes. Future prospective studies are needed to determine if more intensive treatment of moderate to severe IBD improves long-term outcomes in patients undergoing LT for PSC.

Long-Term Follow-Up of Children with Inflammatory Bowel Disease: Evaluation of 53 Cases

2015 ◽  
Vol 13 (2) ◽  
pp. 81-88
Author(s):  
Ömer Faruk Beşer ◽  
Tufan Kutlu ◽  
Fügen Çullu Çokuğraş ◽  
Tülay Erkan
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Long Term Follow Up ◽  
Inflammatory Bowel
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