title: Bariatric surgery in morbidly obese patients with inflammatory bowel disease: A systematic review.
abstract: BACKGROUND
  With increased prevalence of obesity, the number of inflammatory bowel disease (IBD) patients suffering from morbid obesity has raised. It is not clear yet if bariatric surgery is a safe and effective option in this population.
  
  
  OBJECTIVE
  Our systematic review aims to summarize the available literature on the safety and efficacy of bariatric surgery in morbidly obese patients with IBD.
  
  
  METHODS
  University hospital, Iran.
  
  
  METHODS
  A PubMed/MEDLINE search was performed to identify studies reporting the outcome of morbidly obese IBD patients. Postoperative outcome of IBD patients after bariatric surgery were pooled for early and late complications, change of IBD status, and medication alteration.
  
  
  RESULTS
  A total of 7 studies reported post-bariatric surgery outcomes of 43 morbidly obese IBD patients (31 females, 11 males) with an age ranging from 30 to 64 years and a body mass index from 35.7 to 71 kg/m2. Of these, 25 suffered Crohn's disease (CD) (58.2%) and 18 were ulcerative colitis (UC) patients (41.8%). The small bowel was the most common involved gastrointestinal segment in 27.3% of patients. CD patients more commonly underwent sleeve gastrectomy (72%), while UC patients similarly underwent sleeve gastrectomy and Roux-en-Y gastric bypass (44.4%). After a follow-up of 8 to 77 months, IBD patients lost up to 71.4%±5.9% of excess weight and 14.3 kg/m2±5.7 kg/m2of body mass index. There were 9 early (21.4%) and 10 late (23.8%) postoperative complications related to the bariatric procedure. IBD remitted in 20 patients (47.6%), improved in 2 patients (4.8%), but exacerbated in 7 patients (16.7%).
  
  
  CONCLUSIONS
  Although available data on morbidly obese patients with IBD is scarce, bariatric surgery seems to be a safe and effective option for these patients with no added morbidity or mortality. Further studies are necessary to confirm this data.
authors.affiliation: Department of Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: ssht84@yahoo.com.
authors.forename: Saeed
authors.initials: S
authors.lastname: Shoar
authors.affiliation: School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Sayed
authors.initials: S
authors.lastname: Shahabuddin Hoseini
authors.affiliation: School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Naderan
authors.affiliation: Department of Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Habibollah
authors.initials: H
authors.lastname: Mahmoodzadeh
authors.affiliation: College of Medicine, Saint George's Medical School, Grenada.
authors.forename: Fung
authors.initials: F
authors.lastname: Ying Man
authors.affiliation: School of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
authors.forename: Nasrin
authors.initials: N
authors.lastname: Shoar
authors.affiliation: Department of Surgery, Saint Agnes Hospital, Baltimore, MD.
authors.forename: Motahar
authors.initials: M
authors.lastname: Hosseini
authors.affiliation: Department of Emergency Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Shahram
authors.initials: S
authors.lastname: Bagheri-Hariri
mesh_terms: D050110:Bariatric Surgery; D015992:Body Mass Index; D014943:Global Health; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000601:surgery; D009017:Morbidity / Q000639:trends; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Bariatric surgery; Inflammatory bowel diseases; Morbid obesity; Review