Bariatric Procedures Unmasking Celiac Disease

Journal Title: Journal of Obesity and Bariatrics - Year 2014, Vol 1, Issue 1

Abstract

Celiac disease is being recognized more frequently but often remains undiagnosed. Celiac disease patients are increasingly obese. Major operation in patients with celiac disease may cause symptoms which lead to the diagnosis, termed “unmasking.” We report three patients undergoing bariatric procedures which led to unmasking. Three patients undergoing bariatric procedures for morbid obesity were subsequently diagnosed with celiac disease. A 42-yearold female underwent gastric bypass. Her body mass index was 77 preoperatively and open gastric bypass with a 150 cm Roux Limb was performed. At 18 months her body mass index was 51 and she had no diarrhea. A malabsorptive revision moved the Roux Limb connection to 60 cm proximal to the cecum. One year later she had a body mass index of 36 and diarrhea. Persistent diarrhea and weight loss in the following two years led to serologic diagnosis of celiac disease. On a gluten-free diether diarrhea improved and her weight increased 6 kg. A 30-year-old female underwent gastric band. Her body mass index was 46 preoperatively. After multiple adjustments a band slip repair was performed at two years and the band was removed at four years. Body mass index was 42 at that time. Within a few months she developed early satiety, abdominal pain and distension, and hepatomegaly. Serology and histology diagnosed celiac disease and a gluten-free diet was instituted. A 36-year-old female underwent biliopancreatic diversion. Her body mass index was 48 preoperatively and decreased to 22 in two years. Persistent diarrhea led to serologic evaluation for celiac disease. She was started on a gluten-free diet and her body mass index increased to 27 at five years and 30 at ten years postoperatively. Celiac disease should be suspected and evaluated in patients who develop suggestive symptoms after bariatric procedures, including those associated with malabsorption.

Authors and Affiliations

Jon S. Thompson

Keywords

Related Articles

Laparoscopic Revision of Vertical Banded Gastroplasty to Sleeve Gastrectomy for Gastric Outlet Obstruction: Early Experience in Cohort of 18 Patients

Introduction: The long-term effectiveness of Vertical Banded Gastroplasty (VBG) is limited due to development of complications related to gastric outlet obstruction at the band site. Surgical reversal or conversion to Ro...

Revisional Bariatric Surgery

Background: To elucidate percent excess body weight loss (%EBWL) gained from revisional surgery and to determine resolution of comorbid conditions given the obesity epidemic.Methods: All patients undergoing revisional ba...

Challenging Perceptions on Body Image Using a Bariatric Weighted Suit with Female University Dancers

Body image concerns of female dancers have gained a considerable amount of attention due to issues associated with the need to meet the industry’s demand of a particular physique and appearance to impress audiences. This...

The Exaggeration of Food Addiction: Most Weight-Controllers are Athletes, not Addicts

Food addiction has become a popular notion in the media and the scientific community, with many proposing that an addiction to food causes obesity. Although food addictions may affect some people, this notion may also pr...

Pediatric Gastric Bypass: Is it Time to Rethink? Lessons Learned from a Single Institution Experience

Pediatric obesity is a growing problem in United States. Ideally, a non-operative option is preferred but currently there is no medical treatment that guarantees an enduring weight loss. Laparoscopic adjustable gastric b...

Download PDF file
  • EP ID EP205401
  • DOI 10.13188/2377-9284.1000001
  • Views 126
  • Downloads 0

How To Cite

Jon S. Thompson (2014). Bariatric Procedures Unmasking Celiac Disease. Journal of Obesity and Bariatrics, 1(1), 1-3. https://europub.co.uk/articles/-A-205401