Celiac Disease and Bariatric Surgery: A Systematic Review of Current Literature
Bibliographic record
Abstract
Background: Celiac disease (CD) is a clinical entity increasingly recognized in the severe obese population and its impact on outcomes following bariatric surgery is not currently understood. We aimed to systematically review the nutritional and clinical outcomes for patients with obesity and CD following bariatric surgery. Methods: Systematic search of MEDLINE, Embase, Scopus, and Web of Science was conducted in September 2021. Study followed PRISMA guidelines. Studies evaluating adult patients with CD undergoing bariatric surgery were included. Outcomes were descriptive due to limited studies. Results: Our literature review produced 9 studies with 152 patients. The weighted mean age of included patients was 44.2 years (±9.55 years) and 98% (n = 149) were female. Patients diagnosed with CD post-operatively appear to experience substantial perioperative and nutritional complications following bariatric surgery. However, pre-operative diagnosis may allow patient optimization and current studies suggest similar bariatric surgery outcomes can be achieved in these patients when the diagnosis is known. However, this study also highlights a scarcity of evidence evaluating the rate of CD and outcomes for these patients after bariatric surgery. Conclusion: Current literature lacks quality, comparative studies investigating the short- and long-term surgical complications and nutritional outcomes of bariatric surgery within patients who have co-diagnoses of obesity and CD. Despite these limitations, our group recommends pre-operative CD screening in patients experiencing either classical GI symptoms of CD including diarrhea, steatorrhea, bloating, or undifferentiated abdominal pain.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.026 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.005 |
| Bibliometrics | 0.016 | 0.017 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".