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Related Experiment Videos

Bypass enteropathy: an inflammatory process in the excluded segment with systemic complications

E J Drenick, M E Ament, S M Finegold

    The American Journal of Clinical Nutrition
    |January 1, 1977
    PubMed
    Summary

    Jejunoileal bypass complications may stem from inflammation in the bypassed bowel due to bacterial invasion, not just short bowel syndrome. Treating this inflammation with antibiotics or restoring bowel continuity resolves systemic issues.

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    Area of Science:

    • Gastroenterology
    • Surgical Pathology
    • Immunology

    Background:

    • Jejunoileal bypass (JIB) surgery can lead to significant enteric and systemic complications.
    • These complications are often attributed to short bowel syndrome and malabsorption.
    • An alternative hypothesis suggests an inflammatory process within the bypassed bowel segment is involved.

    Observation:

    • Bacterial invasion of the excluded small bowel segment in JIB patients triggers a mucosal inflammatory response.
    • This inflammatory process was observed in the majority of 28 JIB patients, varying in severity.
    • Clinical presentations included symptoms mimicking acute abdomen, small bowel ileus, and colonic distention without organic obstruction.

    Findings:

    • Histological evidence confirmed inflammatory changes in the bypassed bowel mucosa.

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  • Systemic sequelae, such as fever, weight loss, and multi-organ involvement (skin, joints, liver), resemble those seen in inflammatory bowel diseases like Crohn's disease.
  • Clinical improvement with antibiotics (e.g., metronidazole) or surgical reversal of the bypass suggests bacterial involvement in the pathogenesis.

    • Implications:

    • The findings suggest that inflammation within the bypassed bowel segment is a key factor in JIB complications.
    • Understanding this inflammatory mechanism may lead to targeted therapies for JIB patients.
    • This research highlights the potential role of the gut microbiome and associated inflammation in post-surgical complications.