Is metabolic surgery safe in IBD individuals?

Question

Hello doctor,

I am considering metabolic surgery and have a history of inflammatory bowel disease (IBD). I have been struggling with severe obesity (BMI 44) and ulcerative colitis for years. My gastroenterologist has finally managed to get my ulcerative colitis into remission with biologic medications, but now the bariatric surgeon is recommending gastric bypass for my obesity, diabetes, and joint issues. I am worried that the surgery might trigger a terrible flare-up of my IBD. I am also concerned about the potential for malabsorption of my ulcerative colitis medications after the bypass. The surgeon seems dismissive of my concerns about IBD and says that sleeve gastrectomy is not an option due to my acid reflux. Is gastric bypass really safe considering my medical history? Will it affect the efficacy of my ulcerative colitis medications? Could the surgery trigger an autoimmune response? What specific complications should someone with IBD be aware of? I feel like I am being forced to choose between two terrible conditions.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Gastric bypass can be safe for patients with IBD (inflammatory bowel disease), but it may increase the risk of new IBD onset and affect the absorption of UC (ulcerative colitis) medications, requiring dose adjustments. There is a potential risk of triggering autoimmune responses. Specific complications to watch for include strictures, fistulas, and abscesses. Discuss these concerns with your gastroenterologist and bariatric surgeon to weigh the risks and benefits. Your health team can help you make an informed decision that best supports your overall well-being.

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.