Having Crohn’s disease was not something I raised quietly when we started considering gastric sleeve surgery. It was front and centre from the very first consultation. I had been living with Crohn’s for years before our operation in March 2024, and whether it would complicate the surgery, the recovery, or the long-term outcome was something I needed honest answers to before I could commit.
The short version is that I went ahead with the surgery, and two years on, I am glad I did. But the journey was not straightforward, and if you have Crohn’s and are thinking about bariatric surgery, there are things worth understanding before you begin.
What Is Crohn’s Disease?
Crohn’s is a type of inflammatory bowel disease (IBD) that causes chronic inflammation anywhere along the digestive tract, from mouth to bowel. Unlike ulcerative colitis, which affects only the colon, Crohn’s can affect any part of the gut and tends to involve all layers of the bowel wall rather than just the surface lining.
The condition follows a pattern of flares and remission. During a flare, symptoms can include severe abdominal pain, diarrhoea, fatigue, nausea, and significant unintentional weight loss. For many people with Crohn’s, maintaining adequate nutrition is a constant challenge. That is part of what made the idea of deliberately restricting intake through surgery feel counterintuitive at first.
The relationship between Crohn’s and body weight is not simple. Some people with IBD struggle to maintain weight due to poor absorption and frequent flares. Others, particularly those on long-term steroid treatment, experience significant weight gain. I was in the second group. Years of managing the condition, combined with reduced mobility during difficult periods, had contributed to reaching around 18 stone before surgery.
The Concerns Going Into Surgery
Inflammatory bowel disease does raise the surgical risk profile, and anyone considering bariatric surgery with a Crohn’s diagnosis needs to go in with clear eyes about that.
Active Crohn’s disease, particularly if it affects areas of bowel near the surgical site, increases the risk of complications including poor wound healing, infection, and anastomotic leaks. Immunosuppressant medications commonly used to manage Crohn’s can slow healing. Steroids in particular are a concern; most surgical teams want to know your current medication regime and will factor it into their planning.
For these reasons, the standard guidance is that bariatric surgery should be performed during a period of remission rather than active disease. The team at Weight Loss Riga in Latvia were thorough about assessing my Crohn’s status before agreeing to proceed. My gastroenterologist at home was involved in the pre-operative planning, and my condition was well-controlled at the time of surgery. The surgical team were aware of all my medications and managed everything carefully throughout the procedure and my hospital stay.
That coordination between specialists matters enormously. If you are considering surgery, do not assume your bariatric team and your gastroenterologist will automatically communicate. Make it happen explicitly.
The Surgery and Early Recovery
I will not pretend my recovery was identical to James’s. His body had its own complication to navigate, an adverse reaction to anaesthesia that had been flagged pre-op and was managed carefully in theatre. Mine had a different set of considerations.
The first few weeks post-op brought a challenge I had not fully anticipated: distinguishing between normal post-operative discomfort and potential Crohn’s activity. Abdominal cramping and gut disturbance are expected after gastric sleeve surgery for anyone. When you have an inflammatory bowel condition, those same symptoms carry a different weight. Every twinge made me question whether I was dealing with routine recovery or the start of a flare.
I stayed in close contact with my gastroenterologist throughout the first six months. We monitored my inflammatory markers through regular blood tests, and I reported anything that felt out of the ordinary. In the end, I did not experience a significant Crohn’s flare in the immediate post-operative period. But navigating that uncertainty required attention and regular communication with both medical teams in a way that I suspect uncomplicated patients do not have to think about.
How Crohn’s Behaved After Surgery
This is the part where I want to be careful about generalising from personal experience alone, because Crohn’s is a condition that varies considerably between individuals.
My Crohn’s did not worsen as a result of the surgery. As my weight came down from around 18 stone in the months following March 2024, the overall burden on my body reduced noticeably. My energy improved significantly, and the systemic inflammation that comes with carrying substantial excess weight reduced. By the time I hit the one-year mark, I had lost over 8 stone and my general health had improved in ways that went beyond weight alone.
But Crohn’s is still Crohn’s. It is a lifelong condition and surgery did not change that. I still have flares. I still manage my condition with my gastroenterologist and I still take my IBD medication. What has changed is that I am managing it from a stronger physical baseline, with more energy, less systemic inflammation from excess weight, and a healthier overall body. Whether the surgery itself has had any direct effect on my Crohn’s activity, or whether the improvement is entirely down to the weight loss, is something I genuinely cannot separate. The honest answer is probably both.
What the Research Shows
The research on bariatric surgery in patients with inflammatory bowel disease is less extensive than for conditions like hypertension or type 2 diabetes, but what exists is cautiously encouraging. Studies suggest that bariatric surgery is generally safe for IBD patients when performed during remission, with complication rates not substantially higher than for patients without IBD.
There is also emerging evidence that significant weight loss may reduce the frequency and severity of IBD flares in some patients, likely through reductions in systemic inflammation and improvements in immune regulation. Research published in recent years has found that obese patients with IBD who underwent bariatric surgery experienced improvements in their IBD disease activity scores alongside their weight loss outcomes. This does not mean surgery treats Crohn’s, but the anti-inflammatory effect of substantial weight loss may have a secondary benefit for IBD management in some cases.
The picture is not uniformly positive. Post-operative nutritional deficiencies, already a concern after gastric sleeve, may be compounded in Crohn’s patients who have pre-existing issues with nutrient absorption. Monitoring needs to be more thorough and more frequent. My vitamin and supplement regime post-op has been extensive from the outset and remains so two years on.
What to Discuss Before Surgery
If you have Crohn’s disease and are considering gastric sleeve, there are specific conversations you need to have before committing to a date.
Your bariatric surgeon and your gastroenterologist need to communicate directly, not just through notes you pass between them. Ask explicitly whether your current IBD medication will be continued through surgery, whether your Crohn’s is stable enough to proceed, and what the post-operative monitoring plan looks like for your IBD specifically, separate from the standard bariatric follow-up.
Ask whether your surgeon has experience operating on patients with IBD. Not all do. Surgeons less familiar with IBD may not anticipate the ways the condition can affect healing, absorption, or recovery. It is a reasonable question to ask and a good indicator of whether the team is the right fit for your situation.
Understand that your nutritional monitoring post-op will need to be more intensive than for patients without Crohn’s. Deficiencies in iron, B12, vitamin D, and zinc are common after gastric sleeve regardless of IBD status. Crohn’s can independently compromise the absorption of all of these, so the overlap creates a higher risk that needs active management. A dietitian who understands both bariatric nutrition and IBD is worth seeking out if you can find one.
Finally, be realistic about timing. If your Crohn’s is currently in a flare or your disease is poorly controlled, this is not the right moment for elective bariatric surgery. Getting to a stable period of remission first is not just advisable, it is the standard clinical position, and for good reason.
The Honest Conclusion
I would have the surgery again. At around 18 stone pre-op, I was carrying weight that was worsening my quality of life and adding to the systemic burden my body was already dealing with from Crohn’s. The surgery was not without risk for me in the way it might be for someone without an inflammatory bowel condition. But it was an informed risk, taken during a stable period of remission, with the right medical teams involved and communicating.
Two years on, I am over 8 stone lighter, my Crohn’s is managed but not worsened, and my general health is significantly better than it was before surgery. That is the most honest account I can give.
If you are in a similar position and want to talk through what the process looked like for us, feel free to get in touch through the contact page. We are not medical professionals and cannot advise on your individual case, but we are happy to share our experience in more detail.
Sources
NHS. Crohn’s disease. Available at: https://www.nhs.uk/conditions/crohns-disease/
NICE. Crohn’s disease: management. NICE guideline NG129. Available at: https://www.nice.org.uk/guidance/ng129
BOMSS. Guidelines on peri-operative and postoperative biochemical monitoring and micronutrient replacement for patients undergoing bariatric surgery. Available at: https://www.bomss.org.uk/
Aminian A, et al. Bariatric surgery in inflammatory bowel disease. Surgery for Obesity and Related Diseases. Available at: https://www.soard.org/
About this content
This blog is written by James and Kirsten, a couple from the UK who had gastric sleeve surgery together in March 2024.
We started this blog because we couldn't find any sources of content that details before surgery, the surgery and then life post surgery - so we decided to write one ourselves.
Everything on this site is based on our own experience and the research we have done along the way. It is not medical advice. Gastric sleeve surgery is a serious procedure and every patient's journey is different. Please always consult your own bariatric team or GP before making any decisions about your health or treatment.
Some posts on this site may contain featured or sponsored content, or affiliate links. Where this is the case, it will always be clearly stated at the top of the article. Our opinions are always our own.
Publish Date: 12 June 2026 | Last Reviewed: 13 June 2026 | Next Planned Review: 13 December 2027