gastric bybass

Question
I have crohns disease and also diabetes and my doctor suggest that I have the gastric bypass surgery because of my diabetes. Will this mess up my crohns disease? If so will the other surgeries be a better option?

Answer
Donna,
You are right to ask this question, because some doctors believe it is best to avoid abdominal surgery if at all possible in the setting of Crohn's disease.  This opinion comes from the fact that Crohn's can become active at any point on the intestinal tract, so there's a concern that Crohn's may cause problems with the gastric bypass that are difficult to treat.

While I agree that gastric bypass in Crohn's may be an increased risk, I think we all should notice the risk of obesity and the associated diseases (like diabetes) in comparison with the Crohn's risk.  For most patients I've met with Crohn's disease, the risk of the obesity and other diseases has seemed greater than the risk for gastric bypass.  I've done gastric bypass for 5-10 Crohn's patients, and so far it has always worked out well.

You had asked if a different bariatric operation should be done because of your Crohn's, and I would say probably not.  Any bariatric operation could have negative interactions with Crohn's, so it seems reasonable to choose the bariatric operation that will be the most powerful treatment for the diabetes.

Overall, it sounds to me like your surgeon is on the right track.

Good luck!
Dr JP

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