Implications of Celiac Disease Among Patients Undergoing Gastric Bypass.

Journal Article (Journal Article)

INTRODUCTION: Bariatric surgery is generally safe and effective, but co-existing malabsorptive processes may increase the risk of complications or nutritional deficiencies. Bariatric surgery has not been well studied in the setting of pre-existing celiac disease. MATERIALS AND METHODS: Patients who underwent Roux-en-Y gastric bypass (RYGB) from January 2002 to December 2015 were retrospectively reviewed for either diagnosis of or serum testing for celiac disease. Identified patients were re-reviewed for adherence to American Gastroenterological Association (AGA) diagnostic criteria. Patient demographics, operative data, and post-operative weight loss and nutritional parameters were collected. RESULTS: Of the > 12,000 patients who underwent bariatric surgery during this study period, there were 342 patients that had abnormal serology or pathology results. Expert review confirmed three patients (0.8%) with celiac disease diagnosed before RYGB procedure. All were female, with an average age of 33 years and a mean BMI of 44.07 kg/m2. At the time of surgery, two of the three patients were following a gluten-free diet. At 6 months follow-up, mean % excess weight loss was 76.5%. The patients following a gluten-free diet preoperatively continued post-operatively. No patients were anemic nor had vitamin B12 or iron deficiencies at 12-month follow-up. Two patients had vitamin D insufficiencies and responded to daily oral supplementation. CONCLUSION: Though many bariatric patients may carry a presumptive diagnosis of celiac disease, a small percentage of these meet AGA diagnostic criteria. RYGB appears safe in this population with comparable weight loss in non-celiac counterparts. Increased attention to vitamin D levels may be warranted post-operatively.

Full Text

Duke Authors

Cited Authors

  • Freeman, LM; Strong, AT; Sharma, G; Punchai, S; Rodriguez, JH; Kirby, DF; Kroh, M

Published Date

  • June 2018

Published In

Volume / Issue

  • 28 / 6

Start / End Page

  • 1546 - 1552

PubMed ID

  • 29235012

Electronic International Standard Serial Number (EISSN)

  • 1708-0428

Digital Object Identifier (DOI)

  • 10.1007/s11695-017-3046-2

Language

  • eng

Conference Location

  • United States