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Treatment of NASH with Gastric Bypass

  • Stomach and Duodenum (J Pisegna and J Benhammou, Section Editors)
  • Published:
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Abstract

Purpose of Review

Nonalcoholic steatohepatitis (NASH) is a spectrum of nonalcoholic fatty liver disease (NAFLD). It is defined as the presence of fatty liver along with inflammation and hepatocyte injury. To date, weight loss achieved via lifestyle intervention remains the mainstay of NASH treatment. However, given the known benefit of weight loss on NASH and the known effect of bariatric surgery on weight loss, several studies have explored the potential role of bariatric surgery on the treatment of NASH.

Recent Findings

This review article summarizes the evidence on the effect of Roux-en-Y gastric bypass (RYGB), a common bariatric surgery, on NASH therapy. Specifically, studies show that RYGB is associated with an improvement of all NASH histologic features at 1 year.

Summary

Compared to adjustable gastric band, RYGB appears to be superior at treating NASH. Randomized controlled trials and long-term studies are underway to better clarify the role of these procedures specifically for NASH therapy.

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Authors and Affiliations

  1. Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, 02115, USA

    Pichamol Jirapinyo & Christopher C. Thompson

  2. Harvard Medical School, Boston, MA, USA

    Pichamol Jirapinyo & Christopher C. Thompson

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  1. Pichamol Jirapinyo
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  2. Christopher C. Thompson
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Corresponding author

Correspondence to Christopher C. Thompson.

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Conflict of Interest

Christopher Thompson reports receiving consulting fees from Boston Scientific, Covidien, USGI Medical, Valentx, and Apollo Endosurgery; has served as an advisory board member for USGI Medical; has served as an advisory board member for Fractyl; has received research/grant support from USGI Medical and Apollo Endosurgery, laboratory supplies and equipment from Olympus, trial funding from Aspire bariatrics and Spatz; and served as a consultant for Olympus and Fractyl; as an expert reviewer for GI Dynamics, and has an ownership interest in GI Windows.

Pichamol Jirapinyo declares no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Jirapinyo, P., Thompson, C.C. Treatment of NASH with Gastric Bypass. Curr Gastroenterol Rep 20, 49 (2018). https://doi.org/10.1007/s11894-018-0653-6

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