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Weight loss surgery tied to lasting digestive issues

By Lisa Rapaport

(Reuters Health) – A standard weight loss surgery is related to long-term gastrointestinal issues and meals intolerance, a current research suggests.

Researchers examined knowledge on 249 extraordinarily overweight sufferers who had what’s often known as laparoscopic Roux-en-Y gastric bypass, which reduces the abdomen to a small pouch concerning the measurement of an egg.

Two years after surgery, these sufferers had misplaced about 31 % of their complete physique weight on common. But in contrast to the management group of 295 overweight individuals who didn’t have operations, the gastric bypass sufferers have been much more doubtless to expertise indigestion and an lack of ability to tolerate a number of meals.

“It was already known from previous studies that the Roux-en-Y gastric bypass might aggravate gastrointestinal symptoms after surgery,” stated lead research writer Dr. Thomas Boerlage of MC Slotervaart in Amsterdam.

“However, most of these studies concern the first year after surgery,” Boerlage added by e-mail.

At the beginning of the research in 2012, sufferers have been 46 years previous on common. About 45 % of them had hypertension and 29 % had diabetes.

Researchers surveyed all the sufferers and the comparability group of overweight individuals who didn’t have surgery, to ask about 16 totally different gastrointestinal signs. They discovered the postoperative group had 2.2 signs on common, in contrast to 1.eight with the management group.

The commonest gastrointestinal issues included indigestion, abdomen gurgling, flatulence, belching, and exhausting or unfastened stools, researchers report within the British Journal of Surgery.

Hunger pains have been extra pronounced within the non-surgery group.

About 71 % of the postoperative sufferers skilled meals intolerance, in contrast with 17 % within the management group.

Among the subset of surgery sufferers who reported meals intolerance, half of them had an aversion to a minimum of 4 several types of meals and 14 % stated the intolerance was very bothersome.

The meals post-surgery sufferers most frequently reported as being problematic have been fried meals, carbonated drinks, desserts, pies and pastries. Some additionally reported issues with ice cream and spicy meals.

By comparability, individuals within the management group most frequently reported intolerance to milk and fried meals.

There wasn’t any relationship between the quantity of weight loss through the research and the variety of meals intolerances.

Beyond its small measurement, one limitation of the research is that researchers lacked knowledge on signs prior to surgery, making it inconceivable to decide what gastrointestinal or digestive issues may truly be due to the operations, the authors observe.

Even although Roux-en-Y was the most typical sort of gastric bypass when this research was accomplished, one other process generally known as sleeve gastrectomy, which reduces the abdomen to the dimensions of a banana, now accounts for extra operations, stated Dr. Andrei Keidar of Rabin Medical Center and Tel Aviv University in Israel.

“It is more likely to have less gastrointestinal side effects,” Keidar, who wasn’t concerned within the research, stated by e mail.

Gastric bypass sufferers are additionally suggested to keep away from sure meals that could be exhausting to digest after surgery, and most of the sufferers experiencing meals intolerance failed to comply with this recommendation, famous Dr. Anita Courcoulas, a researcher on the University of Pittsburgh Medical Center who wasn’t concerned within the research.

“The top food intolerances included carbonated beverages, fried foods, and red meats, which all potential bypass patients are told to avoid or eliminate,” Courcoulas stated by e-mail. “So while the study provides useful information, it is not surprising.”

Guidelines recommending weight loss surgery as a remedy for diabetes in overweight sufferers have been just lately endorsed by 45 worldwide organizations, diabetes specialists and researchers, together with the International Diabetes Federation, the American Diabetes Association, the Chinese Diabetes Society and Diabetes India.

In most instances, the rules say, surgery can lead to reductions in blood glucose ranges under the Type 2 diabetes analysis threshold or to a considerable enchancment in blood glucose ranges. In many instances this is able to lead to sufferers having the ability to hand over or considerably scale back their diabetes drugs.

SOURCE: British Journal of Surgery, on-line December 19, 2016.

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