Polyarthritis in Obese Patients with Intestinal Bypass

Seven of 31 patients undergoing small-bowel shunt for obesity have developed articular symptoms, an incidence of 23%. All affected patients had a jejunocolostomy instead of a jejunoileostomy. Most of the articular manifestations were transient, lasting only 2 months, but in two patients they were quite severe and lasted over 24 months. In one patient, because of the severe articular symptoms, reconstitution of her bowel to the normal anatomical sequence was performed; she immediately had complete relief and resolution of her symptoms. Apparently the abnormal position of the bowel in some way promoted the development of arthritis in this patient. Intestinal bypass may lead to an arthropathy similar to the more classical enteroarthropathies, and this possibility must be considered when evaluating the total morbidity of the surgical shunt procedure for obesity.