Bowel bypass syndrome

Bowel bypass syndrome is a rare neutrophilic dermatosis characterized by non-specific, flu-like symptoms, arthritis and skin lesions. The first information on the association between intestinal bypass surgery and arthritis was published in the early 1970s. At that time, it was found that 23% of patients (7 out of 31) developed arthritic symptoms after jejunocolostomy due to obesity. In 1979, Dicken and Seehafer were the first to observe the occurrence of inflammatory skin changes in the form of papules and pustules with a diameter of 2 to 4 mm in patients who had undergone intestinal bypass. As this disease was initially associated exclusively with bariatric surgery, the syndrome was given the name "intestinal bypass syndrome". Histopathological examinations revealed similar features to Sweet's syndrome and classified this entity as a neutrophilic dermatosis. A few years later, in 1983, very similar symptoms were observed in four patients, none of whom had intestinal bypass; moreover, each of them suffered from a different gastrointestinal disease. Therefore, it was justified to broaden the clinical picture and rename it"bowel-associated dermatosis-arthritis syndrome" to include these cases. Today, BADAS has been shown to be associated with inflammatory bowel disease (IBD) and small intestinal bacterial overgrowth (SIBO), among others. For more information, see Intestinal-associated dermatosis-arthritis syndrome below.