title: Gastrointestinal symptoms are more intense in morbidly obese patients and are improved with laparoscopic Roux-en-Y gastric bypass.
abstract: BACKGROUND
  Currently there are few reports comparing gastrointestinal (GI) symptoms in the morbidly obese versus control subjects or the effect of laparoscopic Roux-en-Y gastric bypass (LRYGBP) on such symptoms.
  
  
  METHODS
  A previously validated, 19-point GI symptom questionnaire was administered prospectively to each patient undergoing LRYGBP, and the questionnaire was re-administered 6 months postoperatively. Six symptom clusters (abdominal pain, irritable bowel [IBS], reflux, gastroesophageal reflux disease [GERD], sleep disturbances, and dysphagia) were compared in the following manner using Students t-test: 1) Control vs. Preop, 2) Control vs Postop, and 3) Preop vs Postop. Results are expressed as mean +/- standard deviation, significance P=0.05.
  
  
  RESULTS
  43 patients (40 female and 3 male, age 37.3 +/- 8.6, BMI 47.8 +/- 4.9) completed the questionnaire preoperatively, and 36 patients (34 female, 2 male, BMI 31.6 +/- 5.3) completed the questionnaire 6 months postoperatively, for a response-rate of 84%. Abdominal pain, IBS, reflux, GERD and sleep disturbance symptoms were significantly worse in preop versus controls. Dysphagia was not different. Postop vs preop scores revealed abdominal pain, IBS, GERD, reflux, and sleep disturbance symptoms to be improved significantly. Dysphagia was not significantly different. Only dysphagia was worse when comparing postoperative to controls. No other symptom cluster was significantly different in controls vs postoperative.
  
  
  CONCLUSIONS
  Morbidly obese patients experience more intense GI symptoms than control subjects, and many of these symptoms return to control levels 6 months after LRYGBP. Dysphagia is equivalent to control subjects preoperatively but increases significantly after LRYGBP. This data suggests another quality-of-life improvement (relief of GI symptoms) for morbidly obese patients. Further follow-up is needed to document the long-term reduction of GI symptoms.
authors.affiliation: Department of Surgery, University of Alabama-Birmingham, Birmingham, AL, USA. Ronald.Clements@ccc.uab.edu
authors.forename: Ronald H
authors.initials: RH
authors.lastname: Clements
authors.forename: Quintin H
authors.initials: QH
authors.lastname: Gonzalez
authors.forename: Allen
authors.initials: A
authors.lastname: Foster
authors.forename: William O
authors.initials: WO
authors.lastname: Richards
authors.forename: James
authors.initials: J
authors.lastname: McDowell
authors.forename: Anthony
authors.initials: A
authors.lastname: Bondora
authors.forename: Henry L
authors.initials: HL
authors.lastname: Laws
mesh_terms: D000328:Adult; D000713:Anastomosis, Roux-en-Y; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass; D005767:Gastrointestinal Diseases / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors