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Bariatric Surgery-Associated Myelopathy
Sewar Asakly1, Ramit Magen-Rimon1, Ahmad Ighbariya1
1Department of Pediatrics, Ruth Children's Hospital, Rambam Medical Center, Haifa, Israel.
Obesity Facts
|July 26, 2021
Summary
Postbariatric myelopathy is a rare complication following bariatric surgery. Patients experiencing neurological symptoms post-surgery should be evaluated for this condition due to potential immunomodulatory changes.
Area of Science:
- Immunology
- Neurology
- Gastroenterology
Background:
- Bariatric surgery is an effective treatment for morbid obesity in adults and adolescents.
- The post-surgical period can lead to nutritional deficiencies, hormonal shifts, and altered gut microbiome.
- These factors can create an immunomodulatory imbalance and a proinflammatory state.
Observation:
- Changes post-bariatric surgery may affect T cell activity and neural barrier permeability.
- Gut dysbiosis and increased intestinal permeability are observed.
- A shift towards a proinflammatory metabolic profile can occur.
Findings:
- These alterations may precipitate myelopathy, particularly multiple sclerosis (MS), in susceptible individuals.
- Postbariatric myelopathy is a rare but significant neurological complication.
- Genetic predisposition and other risk factors increase the likelihood of developing myelopathy.
Implications:
- Clinicians should consider postbariatric myelopathy in patients presenting with relevant neurological symptoms after surgery.
- Early recognition and management are crucial for affected individuals.
- Further research into the mechanisms linking bariatric surgery to neurological conditions is warranted.
