Bariatric surgery is associated with increased risk of new-onset inflammatory bowel disease: case series and national database study

R. Ungaro, R. Fausel, H. L. Chang, S. Chang, L. A. Chen, A. Nakad, A. El Nawar, I. Prytz Berset, J. Axelrad, G. Lawlor, A. Atreja, L. Roque Ramos, J. Torres, J. F. Colombel

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20 Scopus citations

Abstract

Background: Case series suggest a possible association between bariatric surgery and incident IBD. Aim: The aim of this study was to evaluate the association between bariatric surgery and new-onset IBD. Methods: We first conducted a multi-institutional case series of patients with a history of IBD and bariatric surgery. We next conducted a matched case-control study using medical and pharmacy claims from 2008 to 2012 in a US national database from Source Healthcare Analytics LLC. Bariatric surgery was defined by ICD-9 or CPT code. Bariatric surgery was evaluated as recent (code in database timeframe), past (past history V code) or no history. Conditional logistic regression was used to estimate odds ratios (OR) and 95% CI for new-onset IBD, CD and UC. Results: A total of 15 cases of IBD (10 CD, 4 UC, 1 IBD, type unclassified) with a prior history of bariatric surgery were identified. Most cases were women, had Roux-en-Y surgery years prior to diagnosis and few IBD-related complications. A total of 8980 cases and 43 059 controls were included in our database analysis. Adjusting for confounders, a past history of bariatric surgery was associated with an increased risk of new-onset IBD (OR 1.93, 95% CI 1.34-2.79). However, patients who had recent bariatric surgery did not appear to be at shorter term risk of IBD (OR 0.94, 95% CI 0.58-1.52). Conclusion: New-onset IBD was significantly associated with a past history of bariatric surgery. This potential association needs to be confirmed in future prospective studies.

Original languageEnglish
Pages (from-to)1126-1134
Number of pages9
JournalAlimentary Pharmacology and Therapeutics
Volume47
Issue number8
DOIs
StatePublished - Apr 2018

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