Bariatric surgery: Obesity Weight Loss surgery But Troublesome Side Effects
Gastric bypass is associated with long-term gastrointestinal problems and food intolerances.
Obesity weight loss surgery (bariatric surgery) is increasingly practiced, due to the increasing problems of obesity, but also to its good results. Generally offered to patients with a BMI greater than 40, it not only loses weight effectively, but also treats type 2 diabetes.
Patients and Techniques
In this study published in the British Journal of Surgery, Dutch researchers studied 249 obese patients who underwent a Roux-en-Y gastric bypass operation. At the start of the study in 2012, patients were 46 years old on average. About 45% had high blood pressure and 29% had diabetes. The control group consisted of 295 obese individuals who did not undergo surgery.
Among the techniques of bariatric surgery used are the laying of a gastric band, the sleeve gastrectomy and the gastric bypass. The “Roux-en-Y” bypass operation consists of reducing the stomach into a small pocket that fills up fairly quickly, which promotes the feeling of satiety. The operation also creates a short circuit of a part of the intestine, resulting in poor absorption of food.
Two years after surgery, operated patients had lost an average of 31% of their weight. But, compared to the control group, they suffered much more from indigestion and inability to tolerate certain foods: out of 16 gastrointestinal symptoms tested, the operatives had an average of 2.2 symptoms, compared with 1.8 in the control group . The most frequent problems were indigestion, transit problems, referrals.
71% of the patients operated had food intolerances, compared with 17% in the controls. Of those patients who reported having food intolerances, half were sick with at least four different types of foods. Problematic foods were fried foods, soft drinks, cakes and pastries, and sometimes ice cream and spicy products. By comparison, controls that had intolerances cited rather milk and fried foods.
There was no relationship between the amount of weight lost and the number of food intolerances. However, it should be noted that this study was small and that researchers did not have symptom data before surgery.
The most common bariatric surgery procedure is sleeve gastrectomy: a reduction in the stomach which does not short-circuit the intestine, allowing better absorption of food than with the bypass.
Boerlage TC, van de Laar AW, Westerlaken S, Gerdes VE, Brandjes DP.Gastrointestinal symptoms and food intolerance 2 years after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Br J Surg. 2016 Dec 19. doi: 10.1002 / bjs.10419.