Gastrointestinal symptoms and eating behavior among morbidly obese patients undergoing Roux-en-Y gastric bypass

Abstract

Background and objective: Roux-en-Y gastric bypass (RYGB) changes anatomy and physiology of the gastrointestinal tract, and is followed by gastrointestinal side effects, changes in bowel function and eating behavior. The aim of the present study was to investigate the severity of gastrointestinal symptoms and changes in eating behavior preoperatively and one year after RYGB.

Materials and methods: A total of 180 morbidly obese patients who underwent RYGB were included into the prospective study. Gastrointestinal symptoms were evaluated with Gastroesophageal Reflux Disease-Health Related Quality of Life (GERD-HRQL) questionnaire and Gastrointestinal Symptom Rating Scale (GSRS), eating behavior with Three-Factor Eating Questionnaire before and one year after RYGB. For all patients routine gastroscopy before surgery was performed.

Results: A total of 99 patients (55%) completed one-year follow-up; 79 (43.9%) patients had no pathological findings on preoperative gastroscopy. GERD-HRQL score and GSRS scores of indigestion, constipation, abdominal pain and reflux decreased significantly after surgery. Male gender (OR=2.47, 95% CI 1.11-5.50, P=0.026), GERD-HRQL score (OR=1.28, 95% CI 1.16-1.41, P<0.001) and GSRS diarrhea score (OR=1.89, 95% CI 1.10-3.17, P=0.020) were significant predictors of pathological findings on gastroscopy. Eating behavior one year after RYGB changed significantly as compared to baseline. Cognitive Restraint postoperatively has increased from 42.6 to 55.9 (P<0.001). Uncontrolled Eating and Emotional Eating one year after surgery significantly decreased (59.1 vs. 20.6, P<0.001 and 28.2 vs. 17.2, P<0.001, respectively).

Conclusions: In morbidly obese patients endoscopic findings correlate well with gastrointestinal complain. RYGB significantly improves gastrointestinal complains and eating behavior one year postoperatively.

Keywords: Eating behavior; Gastric bypass; Gastroesophageal reflux; Gastrointestinal symptoms; Morbid obesity; TFEQ.