Effect of Different Bariatric Operations on Food Tolerance and Quality of Eating

Abstract

Many bariatric operations are associated with reduced food tolerance and frequent vomiting, which may cause nutritional deficiencies and influence quality of life. However, the impact of different bariatric procedures on quality of eating and food tolerance has not yet been studied enough. Two hundred and eighteen participants filled a quality of eating questionnaire, at three different time periods after bariatric operation: short-term (3-6 months, n = 63), medium-term (6-12 months, n = 69) and long-term follow-up (over 12 months, n = 86). The participants underwent the following procedures: 99 patients have had Roux-en-Y gastric bypass (RYGB), 49 laparoscopic gastric banding (LAGB), 56 sleeve gastrectomy (SG), and 14 biliopancreatic diversion with duodenal switch (BPD-DS). At short-term period score achieved for all section of the questionnaire was similar for all operations. The total score of the questionnaire at the medium-term group was 20.27 ± 3.57, 14.47 ± 5.92, 22.27 ± 4.66, and 20.91 ± 3.26 (p < 0.001) and the total score for the long-term group of was 21.56 ± 5.16, 15.5 ± 3.75, 20.45 ± 4.9, and 24.2 ± 2.16 (p < 0.001) for RYGB, LAGB, SG, and BPD-DS, respectively. In a linear regression model we found that LAGB patients had a significantly lower total score compared to all other procedures (p < 0.001). Every 1% of %EWL was associated with a total score decrease in 0.045 points (p = 0.009). Impaired quality of eating and food intolerance is common following many types of bariatric procedures. However, the difficulties diminish as time passes after operation and can be affected by the type of procedure. Patients undergoing LAGB have significantly greater limitations and difficulties to ingest variety of foods.

Food Tolerance in Patients Submitted to Gastric Bypass: The Importance of Using an Integrated and Interdisciplinary Approach

“…The prospective study was conducted with four groups of Schweiger et al [3] evaluated the impact of four different surgical procedures, including RYGB, on tolerance and food quality, using the same questionnaire as the present study and found that food tolerance improves over time and is related to surgical procedure. They also observed that patients with a gastric band had the lowest score, characterizing poor food adaptation.…”

“…However, it may persist for more than 1 year in some patients, even when accompanied by a multidisciplinary team, causing long-term nutritional complications [3]. According to Dias et al, the frequency of nausea and vomiting can decrease provided postoperative care is intensified, mainly in relation to eating techniques such as cutting food into small pieces and chewing slowly, habits that could avoid gagging and vomiting.…”

“…Food intolerance problems are similar in the short run, regardless of the surgical technique used, but tend to improve over time [3]. On the other hand, persistent long-term food intolerance leads to nutritional deficiencies, mainly in patients submitted to mixed procedures such as Roux-en-Y gastric bypass (RYGB) [4,5].…”

Assessment of the Effect of Dietary Modifications and Bioenteric Intragastric Balloon Treatment on the Changes of Some Morphological and Biochemical Parameters in Obese Patients

“…A change of pH in a stomach towards alkaline may lead to loo low concentration of intrinsic factor IF, called Castle factor, which can contribute to the deficiency in vitamin B 12 . The risk of B 12 deficiency is described in the course of treatment after bariatric surgeries [41,42]. Taking into consideration the short time of BIB treatment and reversibility of the procedure, maintained levels of vitamin B 12 were assessed as proper and safe [5,43].…”

Medical management of patients after bariatric surgery: Principles and guidelines

“…Nevertheless, fresh fruits and vegetables are usually tolerated without a problem. The daily protein intake should be between 1.0 to 1.5 g/kg ideal body weight per day [24] . The biliopancreatic diversion/duodenal switch (BPD/DS) is a malabsorptive procedure for both macro-and micronutrients.…”