title: Prevalence and co-occurrence of upper and lower functional gastrointestinal symptoms in patients eligible for bariatric surgery.
abstract: BACKGROUND
  Obesity is considered as a risk factor for many functional digestive disorders. The aim of the present study was to evaluate the prevalence and the association of functional digestive symptoms affecting the upper and the lower digestive tract in patients eligible for bariatric surgery.
  
  
  METHODS
  Before surgery, 120 consecutive patients with normal upper endoscopy (7.5% males, mean BMI 44 ± 6 m/kg(2)) have filled a standard questionnaire in order to evaluate the presence of depressive symptoms and functional digestive disorders according to the Rome criteria. The major symptoms (esophageal, gastroduodenal, anorectal, and abdominal pain) were coded as dichotomous variables. Data analysis was performed using multivariate logistic regression with a backwards selection procedure adjusted only for the variables that were significant in univariate analysis (p < 0.05).
  
  
  RESULTS
  Functional symptoms were present in 89% of the subjects (2.5 functional digestive symptoms/subject). Depression symptoms were found in 43% of the patients. Esophageal symptoms were independent predictors for the presence of gastric, bowel, and anorectal symptoms. Functional abdominal pain and bowel symptoms were present, respectively, in 19% and 84% of the patients. Approximately half of the patients have specific functional bowel disorders (28.6% constipation, 18% irritable bowel syndrome, 18% diarrhea, 1% bloating) and 35.7% have non-specific bowel disorders. Anorectal symptoms were found in 40% of the patients: difficult defecation in 32% and fecal incontinence in 9.8% of the patients. Depression was an independent predictor for anorectal symptoms.
  
  
  CONCLUSIONS
  This study shows the high prevalence of functional bowel symptoms in patients complaining of morbid obesity.
authors.affiliation: Diabetes, Nutrition and Endocrinology Department, Avicenne Hospital, Bobigny, France.
authors.forename: Marinos
authors.initials: M
authors.lastname: Fysekidis
authors.forename: Michel
authors.initials: M
authors.lastname: Bouchoucha
authors.forename: Hélène
authors.initials: H
authors.lastname: Bihan
authors.forename: Gérard
authors.initials: G
authors.lastname: Reach
authors.forename: Robert
authors.initials: R
authors.lastname: Benamouzig
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Catheline
mesh_terms: D015746:Abdominal Pain / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000706:statistics & numerical data*; D015331:Cohort Studies; D003109:Colonic Diseases, Functional / Q000453:epidemiology* / Q000523:psychology / Q000601:surgery; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009767:Obesity, Morbid / Q000453:epidemiology* / Q000523:psychology / Q000601:surgery*; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult