Prevalence of Self-reported Symptoms After Gastric Bypass Surgery for Obesity

Gribsholt, Sigrid Bjerge; Pedersen, Ane Mathilde; Svensson, Elisabeth; Thomsen, Reimar Wernich; Richelsen, Bjørn

doi:10.1001/jamasurg.2015.5110

Cited by 101 publications

(92 citation statements)

References 42 publications

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“…Abdominal pain is common after bariatric surgery [31], and the clinical evaluation usually focuses on surgical complications. The current research on IBS in patients with morbid obesity indicate that IBS is an important cause of abdominal pain before bariatric surgery, and probably remains so after surgery [32, 33].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and predictors of irritable bowel syndrome in patients with morbid obesity: a cross-sectional study

et al. 2017

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BackgroundIrritable bowel syndrome has been reported as more common in patients with morbid obesity than in the general population. The reason for this association is unknown. The aims of this study were to study the prevalence of irritable bowel syndrome and other functional bowel disorders in patients with morbid obesity, and to search for predictors of irritable bowel syndrome.MethodsPatients opting for bariatric surgery at two obesity centers in South-Eastern Norway were included. Functional bowel disorders were diagnosed according to the Rome III criteria. Predictors were evaluated in a multivariable logistic regression analysis with irritable bowel syndrome as the dependent variable.ResultsA total of 350 (58%) out of 603 consecutive patients were included. The prevalence rates of irritable bowel syndrome at the two centers were 17/211 (8%) and 37/139 (27%) respectively. High low-density lipoprotein (OR 2.10; 95% CI 1.34–3.29), self-reported psychiatric disorders (OR 2.39; 95% CI 1.12–5.08) and center (OR 5.22; 95% CI 2.48–10.99) were independent predictors of irritable bowel syndrome.ConclusionsAt one of the two obesity centers, the prevalence of irritable bowel syndrome was threefold higher than in the general population in the same region. The high prevalence appears to be related to dietary differences or altered absorption or metabolism of fat. Attention to irritable bowel syndrome is important in the care of patients with morbid obesity.

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Section: Discussionmentioning

confidence: 99%

Prevalence and predictors of irritable bowel syndrome in patients with morbid obesity: a cross-sectional study

et al. 2017

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“…In 0.2-6.6% of all RYGB procedures [12-14], severe symptomatic hypoglycaemia results. This disorder leads to frequent episodes of postprandial hypoglycaemia, with glucose concentrations low enough to cause seizures, loss of consciousness, cognitive dysfunction, disability and death.…”

Section: Introductionmentioning

confidence: 99%

Critical role for GLP-1 in symptomatic post-bariatric hypoglycaemia

et al. 2016

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Aims/hypothesis Post-bariatric hypoglycaemia (PBH) is a rare, but severe, metabolic disorder arising months to years after bariatric surgery. It is characterised by symptomatic postprandial hypoglycaemia, with inappropriately elevated insulin concentrations. The relative contribution of exaggerated incretin hormone signalling to dysregulated insulin secretion and symptomatic hypoglycaemia is a subject of ongoing inquiry. This study was designed to test the hypothesis that PBH and associated symptoms are primarily mediated by glucagon-like peptide-1 (GLP-1). Methods We conducted a double-blinded crossover study wherein eight participants with confirmed PBH were assigned in random order to intravenous infusion of the GLP-1 receptor (GLP-1r) antagonist, exendin (9-39) (Ex-9), or placebo during an OGTT on two separate days at the Stanford University Clinical and Translational Research Unit. Metabolic, symptomatic and pharmacokinetic variables were evaluated. Results were compared with a cohort of BMI- and glucose-matched non-surgical controls (NSCs). Results Infusion of Ex-9 decreased the time to peak glucose and rate of glucose decline during OGTT, and raised the postprandial nadir by over 70%, normalising it relative to NSCs and preventing hypoglycaemia in all PBH participants. Insulin AUC and secretion rate decreased by 57% and 71% respectively, and peak postprandial insulin was normalised relative to NSCs. Autonomic and neuroglycopenic symptoms were significantly reduced during Ex-9 infusion. Conclusions/interpretation GLP-1r blockade prevented hypoglycaemia in 100% of individuals, normalised beta cell function and reversed neuroglycopenic symptoms, supporting the conclusion that GLP-1 plays a primary role in mediating hyperinsulinaemic hypoglycaemia in PBH. Competitive antagonism at the GLP-1r merits consideration as a therapeutic strategy.

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“…Chronic abdominal pain following RYGB is a common presenting symptom leading to a substantial number of clinic visits and hospital admissions annually(4,5,8,9). Typically, upper endoscopic evaluation and abdominal CT are performed.…”

Section: Discussionmentioning

confidence: 99%

“…In light of this altered anatomy, gastric bypass patients are prone to a variety of complications, many of which are known to cause abdominal pain(4,5). Work-up of potential etiologies typically includes upper endoscopy and abdominal computed tomography (CT) to evaluate for possible ulceration or stenosis of the gastrojejunal anastomosis, gastrogastric fistula, gastroesophageal reflux disease, internal hernias or cholelithiasis(6).…”

Section: Introductionmentioning

confidence: 99%