Gastrointestinal symptoms and food intolerance 2 years after laparoscopic Roux-en-Y gastric bypass for morbid obesity
Gastrointestinal symptoms and food intolerance 2 years after laparoscopic Roux-en-Y gastric bypass for morbid obesity
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DOI：
10.1002/bjs.10419
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发表时间：
2017-03-01
影响因子：
9.6
通讯作者：
Brandjes, D. P. M.
中科院分区：
文献类型：
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作者：
Boerlage, T. C. C.;van de Laar, A. W. J. M.;Brandjes, D. P. M.
背景：腹腔镜 Roux-en-Y 胃绕道术 (LRYGB) 是治疗病态肥胖的有效方法，但可能会加重胃肠道不适和食物不耐受。这些症状的长期患病率尚未得到充分研究。 方法：在一项横断面研究中，所有于 2012 年 5 月至 10 月期间接受原发性 LRYGB 的患者在术后 2 年后接受了一般健康问卷、胃肠道症状评定量表 (GSRS) 和食物不耐受问卷的调查。将结果与病态肥胖患者对照组的结果进行比较。结果：总共纳入 249 名患者进行分析，缓解率为 93.9%。平均（标准差）总体重减轻为 30.8（8.7）%。 LRYGB 患者的总平均 GSRS 评分较高（中位数为 2.19，未手术患者为 1.75；P < 0.001）；消化不良症状的差异最为显着（P < 0.001）。 70.7%（95% c.i. 64.8 至 76.0）的术后患者报告对特定产品的食物不耐受，中位数为 4 种食物。食物不耐受与 GSRS 评分呈正相关。食物不耐受或总平均 GSRS 评分与体重减轻之间不存在相关性，但体重减轻与腹痛之间存在相关性。 结论：术后 2 年，因病态肥胖而接受 LRYGB 的患者比肥胖对照患者有更多胃肠道不适。食物不耐受是 LRYGB 的常见副作用，与体重减轻程度或其他腹部症状的存在无关。
Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is an effective treatment for morbid obesity, but might aggravate gastrointestinal complaints and food intolerance. The long-term prevalence of these symptoms has not been well studied.Methods: In a cross-sectional study, all patients who underwent primary LRYGB from May to October 2012 were approached 2 years after surgery to complete a general health questionnaire, the Gastrointestinal Symptom Rating Scale (GSRS), and a food intolerance questionnaire. The results were compared with those for a control group of morbidly obese patients.Results: A total of 249 patients were included for analysis, representing a response rate of 93.9 per cent. Mean(s.d.) total weight loss was 30.8(8.7) per cent. The total mean GSRS score was higher in patients who had LRYGB (median 2.19 versus 1.75 in unoperated patients; P < 0.001); the difference in symptoms of indigestion was most notable (P < 0.001). Food intolerance for specific products was reported by 70.7 (95 per cent c.i. 64.8 to 76.0) per cent of the postoperative patients, for a median of 4 foods. There was a positive correlation between food intolerance and score on the GSRS. There was no correlation between either food intolerance or the total mean GSRS score and weight loss, but there was a correlation between weight loss and abdominal pain.Conclusion: At 2 years after surgery, patients undergoing LRYGB for morbid obesity have more gastrointestinal complaints than obese controls. Food intolerance is a common side-effect of LRYGB independent of degree of weight loss or the presence of other abdominal symptoms.