Bowel bypass syndrome: skin features may resemble Sweet’s syndrome

Links checked 3/04/17.

What is bowel bypass syndrome?

Bowel bypass syndrome (Cheng, 2012).

‘Bowel bypass syndrome is also known as bowel-associated dermatitis-arthritis syndrome and blind loop syndrome.

Bowel bypass syndrome is a relapsing condition characterised by rash and arthritis. It is most commonly associated with bowel shortening surgery, where a ‘blind loop’ of bowel is created. This kind of surgery was previously popular for the treatment of morbid obesity. Up to 20% of patients undergoing bowel bypass surgery develop bowel bypass syndrome.

A similar syndrome has been reported in people who have not had bowel bypass surgery (bowel bypass syndrome without bowel bypass). In these cases associated conditions have included:

  • Diverticulitis.
  • Inflammatory bowel disease.
  • Peptic ulcer disease.

What are the symptoms of bowel bypass syndrome?

Onset of symptoms of bowel bypass syndrome is usually 1-6 years following bowel bypass surgery. Symptoms usually last 2-4 weeks and may recur every 4-6 weeks.

Skin features:

  • Small red bumps (papules), blisters and pustules on trunk and upper arms.
  • May resemble acute neutrophilic dermatosis (Sweet’s syndrome).
  • Erythema nodosum.
  • Panniculitis.

Non-cutaneous features:

  • Fever.
  • Muscle aches and pains.
  • Non-destructive polyarthritis (affecting many joints).
  • Tenosynovitis (inflammation of tendons).’

See ‘References’ to learn more about causes, complications, diagnosis and treatment.

Further medical information.

Ashok, D. and Kiely, P. (2007) Bowel associated dermatosis – arthritis syndrome: a case report. Journal of Medical Case Reports (online).

Oldfield, C., Heffernan-Stroud, L., Buehler-Bota, T. and Williams, J. (2016) Bowel-associated dermatosis-arthritis syndrome (BADAS) in a pediatric patient. Journal of the American Academy of Dermatology, May; 2(3): 272–274 (online).

Patton, T., Jukic, D. and Juhas, E. (2009) Atypical histopathology in bowel-associated dermatosis-arthritis syndrome: A case-report. Dermatology Online Journal. 

Zhao, H., Zhao, L., Shi, W., Luo, H., Duan, L., You, Y., Li, Yand Zuo, X. (2016) Is it bowel-associated dermatosis-arthritis syndrome induced by small intestinal bacteria overgrowth? SpringerPlus, Sep 13;5(1):1551 (online).

References.

Cheng, H. (2012) Bowel bypass syndrome. DermNet NZ (online). Accessed 3/04/17. Information suitable for patients.

© 2012-2017 Sweet’s Syndrome UK

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