New Onset Inflammatory Bowel Disease Risk Following Bariatric Surgery: A Systematic Review and Meta-Analysis of Observational Studies
Abstract
:1. Introduction
2. Materials and Methods
2.1. Literature Search
2.2. Study Selection
2.3. Data Extraction
2.4. Statistical Analysis
3. Results
3.1. Studies’ Characteristics
3.2. The Risk of New Onset IBD Development Following Bariatric Surgery
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Alalwan, A.A.; Friedman, J.; Park, H.; Segal, R.; Brumback, B.A.; Hartzema, A.G. US national trends in bariatric surgery: A decade of study. Surgery 2021, 170, 13–17. [Google Scholar] [CrossRef] [PubMed]
- Yang, B.; Yang, H.P.; Ward, K.K.; Sahasrabuddhe, V.V.; McGlynn, K.A. Bariatric Surgery and Liver Cancer in a Consortium of Academic Medical Centers. Obes. Surg. 2016, 26, 696–700. [Google Scholar] [CrossRef] [PubMed]
- American Society for Metabolic and Bariatric Surgery (ASMBS). Estimate of Bariatric Surgery Numbers, 2011–2021. Published June 2022. Available online: https://asmbs.org/resources/estimate-of-bariatric-surgery-numbers (accessed on 2 October 2023).
- Ma, I.T.; Madura, J.A., 2nd. Gastrointestinal Complications After Bariatric Surgery. Gastroenterol. Hepatol. 2015, 11, 526–535. [Google Scholar]
- Gribsholt, S.B.; Pedersen, A.M.; Svensson, E.; Thomsen, R.W.; Richelsen, B. Prevalence of Self-reported Symptoms after Gastric Bypass Surgery for Obesity. JAMA Surg. 2016, 151, 504–511. [Google Scholar] [CrossRef] [PubMed]
- Johnson, A.M.; Loftus, E.V. Impact of Obesity on the Management of Inflammatory Bowel Disease. Gastroenterol. Hepatol. 2020, 16, 350–359. [Google Scholar]
- Kim, J.H.; Oh, C.M.; Yoo, J.H. Obesity and novel management of inflammatory bowel disease. World J. Gastroenterol. 2023, 29, 1779–1794. [Google Scholar] [CrossRef] [PubMed]
- Fuschillo, G.; Celentano, V.; Rottoli, M.; Sciaudone, G.; Gravina, A.G.; Pellegrino, R.; Marfella, R.; Romano, M.; Selvaggi, F.; Pellino, G. Influence of diabetes mellitus on inflammatory bowel disease course and treatment outcomes. A systematic review with meta-analysis. Dig. Liver Dis. 2023, 55, 580–586. [Google Scholar] [CrossRef] [PubMed]
- Wise, J.; Plescia, T.; Cummings, B.P.; Lyo, V. Exploring the Relationship Between Bariatric Surgery and Inflammatory Bowel Disease: A Systematic Review. Crohns Colitis 360 2022, 4, otac013. [Google Scholar] [CrossRef]
- Mian, A.; Khan, S. Systematic review: Outcomes of bariatric surgery in patients with inflammatory bowel disease and de-novo IBD development after bariatric surgery. Surgeon 2023, 21, e71–e77. [Google Scholar] [CrossRef]
- Huang, C.S.; Forse, R.A.; Jacobson, B.C.; Farraye, F.A. Endoscopic findings and their clinical correlations in patients with symptoms after gastric bypass surgery. Gastrointest. Endosc. 2003, 58, 859–866. [Google Scholar] [CrossRef]
- Braga Neto, M.B.; Gregory, M.; Ramos, G.P.; Loftus, E.V.; Ciorba, M.A.; Bruining, D.H.; Bazerbachi, F.; Abu Dayyeh, B.K.; Kushnir, V.M.; Shah, M.; et al. De-novo Inflammatory Bowel Disease after Bariatric Surgery: A Large Case Series. J. Crohns Colitis 2018, 12, 452–457. [Google Scholar] [CrossRef] [PubMed]
- Kermansaravi, M.; Valizadeh, R.; Farazmand, B.; Mousavimaleki, A.; Taherzadeh, M.; Wiggins, T.; Singhal, R. De Novo Inflammatory Bowel Disease Following Bariatric Surgery: A Systematic Review and Meta-analysis. Obes. Surg. 2022, 32, 3426–3434. [Google Scholar] [CrossRef] [PubMed]
- Page, M.J.; McKenzie, J.E.; Bossuyt, P.M.; Boutron, I.; Hoffmann, T.C.; Mulrow, C.D.; Shamseer, L.; Tetzlaff, J.M.; Akl, E.A.; Brennan, S.E.; et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ 2021, 372, n71. [Google Scholar] [CrossRef] [PubMed]
- Wells, G.A.; Shea, B.; O’Connell, D.; Peterson, J.; Welch, V.; Losos, M.; Tugwell, P. The NewcastleOttawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-Analysis. Available online: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp (accessed on 21 February 2024).
- Kiasat, A.; Granström, A.L.; Stenberg, E.; Gustafsson, U.O.; Marsk, R. The risk of inflammatory bowel disease after bariatric surgery. Surg. Obes. Relat. Dis. 2022, 18, 343–350. [Google Scholar] [CrossRef]
- Allin, K.H.; Jacobsen, R.K.; Ungaro, R.C.; Colombel, J.-F.; Egeberg, A.; Villumsen, M.; Jess, T. Bariatric Surgery and Risk of New-onset Inflammatory Bowel Disease: A Nationwide Cohort Study. J. Crohns Colitis 2021, 15, 1474–1480. [Google Scholar] [CrossRef] [PubMed]
- Kochhar, G.S.; Desai, A.; Syed, A.; Grover, A.; El Hachem, S.; Abdul-Baki, H.; Chintamaneni, P.; Aoun, E.; Kanna, S.; Sandhu, D.S.; et al. Risk of de-novo inflammatory bowel disease among obese patients treated with bariatric surgery or weight loss medications. Aliment. Pharmacol. Ther. 2020, 51, 1067–1075. [Google Scholar] [CrossRef]
- Ungaro, R.; Fausel, R.; Chang, H.L.; Chang, S.; Chen, L.A.; Nakad, A.; El Nawar, A.; Berset, I.P.; Axelrad, J.; Lawlor, G.; et al. Bariatric surgery is associated with increased risk of new-onset inflammatory bowel disease: Case series and national database study. Aliment. Pharmacol. Ther. 2018, 47, 1126–1134. [Google Scholar] [CrossRef]
- Nagalingam, N.A.; Lynch, S.V. Role of the microbiota in inflammatory bowel diseases. Inflamm. Bowel Dis. 2012, 18, 968–984. [Google Scholar] [CrossRef]
- Cani, P.D.; Delzenne, N.M. Gut microflora as a target for energy and metabolic homeostasis. Curr. Opin. Clin. Nutr. Metab. Care 2007, 10, 729–734. [Google Scholar] [CrossRef]
- Luijten, J.C.H.B.M.; Vugts, G.; Nieuwenhuijzen, G.A.P.; Luyer, M.D.P. The Importance of the Microbiome in Bariatric Surgery: A Systematic Review. Obes. Surg. 2019, 29, 2338–2349. [Google Scholar] [CrossRef]
- Lee, C.J.; Florea, L.; Sears, C.L.; Maruthur, N.; Potter, J.J.; Schweitzer, M.; Magnuson, T.; Clark, J.M. Changes in Gut Microbiome after Bariatric Surgery Versus Medical Weight Loss in a Pilot Randomized Trial. Obes. Surg. 2019, 29, 3239–3245. [Google Scholar] [CrossRef] [PubMed]
- Lane, E.R.; Zisman, T.L.; Suskind, D.L. The microbiota in inflammatory bowel disease: Current and therapeutic insights. J. Inflamm. Res. 2017, 10, 63–73. [Google Scholar] [CrossRef] [PubMed]
- Crommen, S.; Mattes, A.; Simon, M.C. Microbial Adaptation Due to Gastric Bypass Surgery: The Nutritional Impact. Nutrients 2020, 12, 1199. [Google Scholar] [CrossRef]
- Rahmani, J.; Kord-Varkaneh, H.; Hekmatdoost, A.; Thompson, J.; Clark, C.; Salehisahlabadi, A.; Day, A.S.; Jacobson, K. Body mass index and risk of inflammatory bowel disease: A systematic review and dose-response meta-analysis of cohort studies of over a million participants. Obes. Rev. 2019, 20, 1312–1320. [Google Scholar] [CrossRef]
- Bhagavathula, A.S.; Clark, C.C.T.; Rahmani, J.; Chattu, V.K. Impact of Body Mass Index on the Development of Inflammatory Bowel Disease: A Systematic Review and Dose-Response Analysis of 15.6 Million Participants. Healthcare 2021, 9, 35. [Google Scholar] [CrossRef] [PubMed]
- Holt, D.Q.; Moore, G.T.; Strauss, B.J.; Hamilton, A.L.; De Cruz, P.; Kamm, M.A. Visceral adiposity predicts post-operative Crohn’s disease recurrence. Aliment. Pharmacol. Ther. 2017, 45, 1255–1264. [Google Scholar] [CrossRef] [PubMed]
- Mentella, M.C.; Scaldaferri, F.; Pizzoferrato, M.; Gasbarrini, A.; Miggiano, G.A.D. The Association of Disease Activity, BMI and Phase Angle with Vitamin D Deficiency in Patients with IBD. Nutrients 2019, 11, 2583. [Google Scholar] [CrossRef] [PubMed]
- Galyean, S.; Syn, D.; Subih, H.S.; Boylan, M. Improving vitamin D status in bariatric surgery subjects with monthly high-dose ergocalciferol. Int. J. Vitam. Nutr. Res. 2022, 92, 109–117. [Google Scholar] [CrossRef] [PubMed]
- Aminian, A.; Andalib, A.; Ver, M.R.; Corcelles, R.; Schauer, P.R.; Brethauer, S.A. Outcomes of Bariatric Surgery in Patients with Inflammatory Bowel Disease. Obes. Surg. 2016, 26, 1186–1190. [Google Scholar] [CrossRef]
- Mabeza, R.M.; Vadlakonda, A.; Chervu, N.; Ebrahimian, S.; Sakowitz, S.; Yetasook, A.; Benharash, P. Short-term outcomes of bariatric surgery in patients with inflammatory bowel disease: A national analysis. Surg. Obes. Relat. Dis. 2024, 20, 146–152. [Google Scholar] [CrossRef] [PubMed]
Author | Journal | Year | Study Design | Country | Study Population | Sample Size | Sex (M:F) | Surgery Type | IBD | CD | UC | Follow-Up | Factors Adjusted for |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Kiasat et al. [16] | Surgery for Obesity and Related Diseases | 2022 | Retrospective cohort | Sweden | Scandinavian Obesity Surgery Registry (SOReg) | 698,718 | 165,067 (M) 533,651 (F) | RYGB: 54,465 SG: 9723 | Controls: 2006 BS: 285 RYGB: 264 SG: 21 | Controls: 701 BS: 123 RYGB: 119 SG: 4 | Controls: 1116 BS: 111 RYGB: 97 SG: 14 | Controls: 3,444,186 person-years Cases: 346,860 person-years | Sex, age and preoperative BMI, for SG |
Allin et al. [17] | Journal of Crohn’s and Colitis | 2021 | Prospective cohort | Denmark | Danish Civil Registration System | 3,917,843 | 2,001,473 (M) 1,916,370 (F) | RYGB: 13,827 SG: 937 GB: 583 | Controls: 35,294 BS: 100 | Controls: 11,199 BS: 51 | Controls: 23,955 BS: 49 | 14.8 years (median) | Age, sex, birth cohort, education and number of obesity-related comorbidities |
Kochhar et al. [18] | Alimentary Pharmacology & Therapeutics | 2020 | Retrospective cohort | USA | Health Insurance Portability and Accountability Act compliant database | 59,000 | 22,078 (M) 36,922 (F) | RYGB SG GB | Controls: 58,530 BS: 470 | Controls: 31,110 BS: 260 | Controls: 27,420 BS: 210 | - | - |
Ungaro et al. [19] | Alimentary Pharmacology & Therapeutics | 2018 | Matched case–control | USA | Symphony Health Solutions LLC (SHA) Integrated Dataverse (IDV) | 52,039 | 19,934 (M) 32,105 (F) | RYGB SG GB | - | - | - | 4.3 years (mean) | Age, obesity and medications exposure |
Cohort Studies | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|
Selection | Comparability | Outcome | ||||||||
Studies | Representativeness | Selection of non-exposed | Exposure ascertainment | The outcome of interest was not present at start of study | Age | Controlled factors | Outcome assessment | Follow-up period | Follow-up adequacy | Total * |
Kiasat et al. [16] | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 9 |
Allin et al. [17] | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 9 |
Kochhar et al. [18] | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 7 |
Case–control studies | ||||||||||
Selection | Comparability | Exposure | ||||||||
Studies | Case definition adequacy | Representativeness | Controls selection | Controls definition | Controlled factors | Controlled additional factors | Exposure ascertainment | Method of ascertainment | Non-response rate | Total * |
Ungaro et al. [19] | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 9 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Aldhaleei, W.A.; Odah, T.; Bakheet, N.; Jett, H.; Hashash, J.G.; Wallace, M.B.; Kumbhari, V.; Farraye, F.A.; Bhagavathula, A.S. New Onset Inflammatory Bowel Disease Risk Following Bariatric Surgery: A Systematic Review and Meta-Analysis of Observational Studies. Gastroenterol. Insights 2024, 15, 708-719. https://doi.org/10.3390/gastroent15030050
Aldhaleei WA, Odah T, Bakheet N, Jett H, Hashash JG, Wallace MB, Kumbhari V, Farraye FA, Bhagavathula AS. New Onset Inflammatory Bowel Disease Risk Following Bariatric Surgery: A Systematic Review and Meta-Analysis of Observational Studies. Gastroenterology Insights. 2024; 15(3):708-719. https://doi.org/10.3390/gastroent15030050
Chicago/Turabian StyleAldhaleei, Wafa A., Tarek Odah, Nader Bakheet, Heather Jett, Jana G. Hashash, Michael B. Wallace, Vivek Kumbhari, Francis A. Farraye, and Akshaya Srikanth Bhagavathula. 2024. "New Onset Inflammatory Bowel Disease Risk Following Bariatric Surgery: A Systematic Review and Meta-Analysis of Observational Studies" Gastroenterology Insights 15, no. 3: 708-719. https://doi.org/10.3390/gastroent15030050