Expert: John Pilcher, MD - 9/13/2009

Question
Hi

I am a 52 year old woman and weigh approximately 246 lbs.  I have yoyo dieted all my adult life and now am at my heaviest. It was thought that I had Ulcerative Colitis/Proctitis but this diagnosis recently changed to Crohn's.

Can you confirm that I gain weight because the disease is confined to the large intestine?..As I never lose weight during flare-ups.

Can you please tell me if a Gastric Sleeve would be beneficial to my health as it is not malabsorbtivea and how it would be beneficial?...I dread having to take steroids at some point during the course of disease and gaining an even more dangerous amount of weight.

Kind Regards
Snow

Answer
Snow,
I am not able to form an opinion about the distribution of your inflammatory bowel disease and possible relation to weight gain.

However, I am able to say that bariatric surgery remains a reasonable option in spite of your inflammatory bowel disease.  Further, I believe that most bariatric surgeons would favor the sleeve over a gastric bypass or a gastric band in the setting of Crohn's.  The sleeve is understood to be preferred in these circumstances because it is thought to be less susceptible to inflammatory complications than the Band or the gastric bypass.

For your clarity, there is some degree of malabsorption with the sleeve due to loss of the digestive factors from the large resected part of the stomach - the exact nature of this absorption deficiency is under study.

Best of luck,
Dr JP