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Risk of de-novo inflammatory bowel disease among obese patients treated with bariatric surgery or weight loss medications.
Aliment Pharmacol Ther. 2020 06; 51(11):1067-1075.AP

Abstract

BACKGROUND

An association between bariatric surgery and development of de-novo inflammatory bowel disease (IBD) has been observed.

AIM

To evaluate further the association among bariatric surgery, weight loss medications, obesity and new-onset IBD.

METHODS

Using Explorys, a population-based Health Insurance Portability and Accountability Act compliant database, we estimated the prevalence of de-novo IBD among patients treated with bariatric surgery (Roux-en-Y gastrojejunostomy, laparoscopic sleeve gastrectomy or gastric banding) (n = 60 870) or weight loss medications (orlistat, phentermine/topiramate, lorcaserin, bupropion/naltrexone and liraglutide) (n = 193 790) compared with obese controls (n = 5 021 210), between 1999 and 2018.

RESULTS

The prevalence of de-novo IBD was lower among obese patients exposed to bariatric surgery (7.72 per 1000 patients) or weight loss medications (7.22 per 1000 patients) compared with patients with persistent obesity not exposed to these interventions (11.66 per 1000 patients, P < 0.0001). The risk reduction for de-novo IBD was consistent across bariatric surgeries and weight loss medications with the exception of orlistat which was not associated with a reduction in risk for de-novo IBD compared with the persistent obese control cohort.

CONCLUSION

Obese patients undergoing treatment with bariatric surgery or weight loss medications are at a lower risk for developing de-novo IBD compared with persistently obese controls not exposed to these interventions. These data suggest that obesity and ineffective management of obesity are risk factors for de-novo IBD. Further research is needed to confirm these observations and understand potential mechanisms.

Authors+Show Affiliations

Division of Gastroenterology, Hepatology & Nutrition, Allegheny Health Network, Pittsburgh, PA, USA.Department of Medicine, MetroHealth Medical Center/Case Western Reserve University, Cleveland, OH, USA.Division of Gastroenterology, Hepatology & Nutrition, Allegheny Health Network, Pittsburgh, PA, USA. Department of Medicine, MetroHealth Medical Center/Case Western Reserve University, Cleveland, OH, USA.Division of Gastroenterology, Hepatology & Nutrition, Allegheny Health Network, Pittsburgh, PA, USA.Division of Gastroenterology, Hepatology & Nutrition, Allegheny Health Network, Pittsburgh, PA, USA.Division of Gastroenterology, Hepatology & Nutrition, Allegheny Health Network, Pittsburgh, PA, USA.Division of Gastroenterology, Hepatology & Nutrition, Allegheny Health Network, Pittsburgh, PA, USA.Division of Gastroenterology, Hepatology & Nutrition, Allegheny Health Network, Pittsburgh, PA, USA.Division of Gastroenterology, Hepatology & Nutrition, Allegheny Health Network, Pittsburgh, PA, USA.Division Gastroenterology & Hepatology, MetroHealth Medical Center, Cleveland, OH, USA.Division Gastroenterology & Hepatology, University of California, San Diego, CA, USA.Center for Inflammatory Bowel Disease, Columbia University Irving Medical Center/New York Presbyterian Hospital, New York, NY, USA.Division Gastroenterology & Hepatology, Mayo Clinic, Rochester, MN, USA.Division Gastroenterology & Hepatology, University of California, San Diego, CA, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32319111

Citation

Kochhar, Gursimran S., et al. "Risk of De-novo Inflammatory Bowel Disease Among Obese Patients Treated With Bariatric Surgery or Weight Loss Medications." Alimentary Pharmacology & Therapeutics, vol. 51, no. 11, 2020, pp. 1067-1075.
Kochhar GS, Desai A, Syed A, 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(11):1067-1075.
Kochhar, G. S., Desai, A., Syed, A., Grover, A., El Hachem, S., Abdul-Baki, H., Chintamaneni, P., Aoun, E., Kanna, S., Sandhu, D. S., Singh, S., Shen, B., Loftus, E. V., & Dulai, P. S. (2020). Risk of de-novo inflammatory bowel disease among obese patients treated with bariatric surgery or weight loss medications. Alimentary Pharmacology & Therapeutics, 51(11), 1067-1075. https://doi.org/10.1111/apt.15721
Kochhar GS, 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(11):1067-1075. PubMed PMID: 32319111.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of de-novo inflammatory bowel disease among obese patients treated with bariatric surgery or weight loss medications. AU - Kochhar,Gursimran S, AU - Desai,Aakash, AU - Syed,Aslam, AU - Grover,Abhinav, AU - El Hachem,Sandra, AU - Abdul-Baki,Heitham, AU - Chintamaneni,Preethi, AU - Aoun,Elie, AU - Kanna,Sowjanya, AU - Sandhu,Dalbir S, AU - Singh,Siddharth, AU - Shen,Bo, AU - Loftus,Edward V,Jr AU - Dulai,Parambir S, Y1 - 2020/04/21/ PY - 2019/11/07/received PY - 2019/12/04/revised PY - 2020/03/22/accepted PY - 2020/4/23/pubmed PY - 2020/4/23/medline PY - 2020/4/23/entrez SP - 1067 EP - 1075 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 51 IS - 11 N2 - BACKGROUND: An association between bariatric surgery and development of de-novo inflammatory bowel disease (IBD) has been observed. AIM: To evaluate further the association among bariatric surgery, weight loss medications, obesity and new-onset IBD. METHODS: Using Explorys, a population-based Health Insurance Portability and Accountability Act compliant database, we estimated the prevalence of de-novo IBD among patients treated with bariatric surgery (Roux-en-Y gastrojejunostomy, laparoscopic sleeve gastrectomy or gastric banding) (n = 60 870) or weight loss medications (orlistat, phentermine/topiramate, lorcaserin, bupropion/naltrexone and liraglutide) (n = 193 790) compared with obese controls (n = 5 021 210), between 1999 and 2018. RESULTS: The prevalence of de-novo IBD was lower among obese patients exposed to bariatric surgery (7.72 per 1000 patients) or weight loss medications (7.22 per 1000 patients) compared with patients with persistent obesity not exposed to these interventions (11.66 per 1000 patients, P < 0.0001). The risk reduction for de-novo IBD was consistent across bariatric surgeries and weight loss medications with the exception of orlistat which was not associated with a reduction in risk for de-novo IBD compared with the persistent obese control cohort. CONCLUSION: Obese patients undergoing treatment with bariatric surgery or weight loss medications are at a lower risk for developing de-novo IBD compared with persistently obese controls not exposed to these interventions. These data suggest that obesity and ineffective management of obesity are risk factors for de-novo IBD. Further research is needed to confirm these observations and understand potential mechanisms. SN - 1365-2036 UR - https://www.unboundmedicine.com/medline/citation/32319111/Risk_of_de-novo_inflammatory_bowel_disease_among_obese_patients_treated_with_bariatric_surgery_or_weight_loss_medications L2 - https://doi.org/10.1111/apt.15721 DB - PRIME DP - Unbound Medicine ER -
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