Tuberculosis after jejuno-ileal bypass for morbid obesity

Werbin, Nahum

doi:10.1136/pgmj.57.666.252

Cited by 5 publications

(1 citation statement)

References 13 publications

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“…Jejunoileal bypass has become less popular due to a higher incidence of complications and availability of alternative surgical procedures for morbid obesity. According to one study, 14 cases of pulmonary TB were observed in patients who underwent jejunoileal bypass [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Tuberculosis After Gastric Bypass: A Very Rare Complication

Haq

Talib

Ans

et al. 2018

Cureus

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Laparoscopic Roux-en-Y gastric bypass (RYGB) is the most commonly performed bariatric surgical procedure with successful outcomes. RYGB has multiple positive outcomes, including sustained weight reduction, resolution of co-morbidities and improvement in the overall health. RYGB has many complications like any other surgery, but the development of tuberculosis (TB) either pulmonary or extra-pulmonary secondary to RYGB is very rare. We present a 32-year-old female with the history of a successful RYGB three years ago, who presented with signs and symptoms of possible TB which was later confirmed with sputum acid-fast bacilli and sputum culture. She was treated with anti-tuberculosis treatment (ATT) drugs for six months with complete resolution of her symptoms. We recommend raising awareness in the health care professionals about this rare complication of RYGB in the need of time.

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Section: Discussionmentioning

confidence: 99%

Pulmonary Tuberculosis After Gastric Bypass: A Very Rare Complication

Haq

Talib

Ans

et al. 2018

Cureus

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Nutrition in HIV and Tuberculosis

Baum

Tamargo

Wanke

2020

Nutrition and Infectious Diseases

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Trends in oral drug bioavailability following bariatric surgery: examining the variable extent of impact on exposure of different drug classes

Darwich

Henderson

Burgin

et al. 2012

Brit J Clinical Pharma

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WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Changes to oral drug bioavailability have been observed post bariatric surgery. However, the magnitude and the direction of changes have not been assessed systematically to provide insights into the parameters governing the observed trends. Understanding these can help with dose adjustments. WHAT THIS STUDY ADDS • Analysis of drug characteristics based on a biopharmaceutical classification system is not adequate to explain observed trends in altered oral drug bioavailability following bariatric surgery, although the findings suggest solubility to play an important role. AIMS To identify the most commonly prescribed drugs in a bariatric surgery population and to assess existing evidence regarding trends in oral drug bioavailability post bariatric surgery. METHODS A retrospective audit was undertaken to document commonly prescribed drugs amongst patients undergoing bariatric surgery in an NHS hospital in the UK and to assess practice for drug administration following bariatric surgery. The available literature was examined for trends relating to drug permeability and solubility with regards to the Biopharmaceutics Classification System (BCS) and main route of elimination. RESULTS No significant difference in the ‘post/pre surgery oral drug exposure ratio’ (ppR) was apparent between BCS class I to IV drugs, with regards to dose number (Do) or main route of elimination. Drugs classified as ‘solubility limited’ displayed an overall reduction as compared with ‘freely soluble’ compounds, as well as an unaltered and increased ppR. CONCLUSION Clinical studies establishing guidelines for commonly prescribed drugs, and the monitoring of drugs exhibiting a narrow therapeutic window or without a readily assessed clinical endpoint, are warranted. Using mechanistically based pharmacokinetic modelling for simulating the multivariate nature of changes in drug exposure may serve as a useful tool in the further understanding of postoperative trends in oral drug exposure and in developing practical clinical guidance.

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Tuberculosis after jejuno-ileal bypass for morbid obesity

Cited by 5 publications

References 13 publications

Pulmonary Tuberculosis After Gastric Bypass: A Very Rare Complication

Pulmonary Tuberculosis After Gastric Bypass: A Very Rare Complication

Nutrition in HIV and Tuberculosis

Trends in oral drug bioavailability following bariatric surgery: examining the variable extent of impact on exposure of different drug classes

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