Ethnic Variations and Their Consequences: Ulcerative Colitis After Bariatric Procedures

Background:
Bariatric surgery effectively treats obesity and boosts metabolic health, but it may increase ulcerative colitis (UC) incidence, particularly after the Roux-en-Y gastric bypass. The influence of race on UC occurrence post-surgery remains unexplored. Considering the link between obesity and UC, investigating racial effects is vital. This study will determine if racial differences affect UC risk post-bariatric surgery, aiming to enhance patient outcomes and optimize post-surgical care.
Methods:
Our retrospective study reviewed bariatric surgery patients at our facility from 2009 to 2022, excluding those with prior UC. We collected data on comorbidities, insurance, surgical types, colonoscopy, and pathology reports using ICD and CPT codes. Monitoring continued until 2023, categorizing patients by gender, race, and elapsed time post-surgery. Propensity score matching balanced characteristics. Kaplan-Meier and Cox models analyzed UC onset timing by race, and odds ratios identified factors affecting outcomes.
Results:
Between 2009 and 2022, our facility performed 960 bariatric surgeries. Of these procedures, 24 patients (or 0.02%) were diagnosed with UC, typically identified around 80±14.2 months post-surgery. The mean age of the participants was approximately 46±11.8 years, and females constituted 54.2% of the cohort. When examining racial breakdowns, 38.39% were African Americans, 24.4% were whites, 21% were Asians, and 16.21% were Hispanics. Notably, White patients manifested UC within a considerably shorter duration than other racial groups (Breslow: 11.836, p=0.022). Additionally, a heightened risk of UC was observed among individuals from the lowest income bracket (OR: 3.15, P=0.041), emphasizing the influence of socioeconomic status on health outcomes.
Conclusions:
This study addresses the gap in understanding race’s impact on UC post-bariatric surgery. Analyzing 960 cases from 2009-2022, we found a 0.02% UC incidence, typically manifesting around 45 months post-operation. Notably, Hispanic patients developed UC sooner than other races, with lower-income individuals at higher risk. These findings underscore the necessity of taking into account racial and socioeconomic factors in post-surgical care. Further research could result in interventions that.