Inflammatory bowel disease in the obese patient

Abstract

Obesity is becoming increasingly more common among patients with inflammatory bowel disease. In this review, we will explore the epidemiological trends of inflammatory bowel disease, the complex interplay between the proinflammatory state of obesity and inflammatory bowel disease, outcomes of surgery for inflammatory bowel disease in obese as compared with non-obese patients, and technical concerns pertaining to restorative proctocolectomy and ileoanal pouch reservoir, stoma creation and laparoscopic surgery for inflammatory bowel disease in obese patients.

Keywords: Crohn's disease; Obesity; inflammatory bowel disease; laparoscopy; restorative proctocolectectomy; ulcerative colitis.

Figure 1

(A) Transverse incisions of the peritoneal layers of the small bowel mesentery to gain length when constructing an ileoanal pouch reservoir. (B) Ligation of the ileocolic artery to increase reach of small bowel when fashioning an ileoanal pouch reservoir. (Both reprinted with permission, Cleveland Clinic Center for Medical Art & Photography © 1998–2011. All Rights Reserved.)

Figure 2

Exteriorizing the bowel for an ileostomy in two steps: through the fascia followed by the subcutaneous tissues. (Reprinted with permission, Cleveland Clinic Center for Medical Art & Photography © 1998–2011. All Rights Reserved.)

Figure 3

Use of a wound protector as a conduit for exteriorizing the bowel for a stoma. (Reprinted with permission, Cleveland Clinic Center for Medical Art & Photography © 1998–2011. All Rights Reserved.)