Food and Gastrointestinal Habits After Bariatric Surgery

Study Overview
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Brief Summary
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The worldwide epidemic of overweight and obesity affects about 1.7 billion people around the world. Since 1991, many international medical societies have established as recommendation for bariatric surgery the unsuccessful clinical treatment in patients with IMC > 40Kg/m2 or IMC > 35Kg/m2 in the cases with serious co-morbidities related to the possible reversion of them with the lose of weight due to the surgery. In front of the new anatomical condition from the gastrointestinal tract the patients present changes in food preferences and in the food intake, which include modifications in food choices, perception of hungry and satiety and in the tolerance to determinate food. These changes in food intake of the patients are observed mostly in the first year after the surgery an adaptive phase to a new condition.

Detailed Description
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After the new anatomical condition of the gastrointestinal tract, provided by bariatric surgery leads patients to experience changes in food intake and behavior. The aim of this study was to assess alimentary habits, food intolerances and gastrointestinal symptoms in patients who underwent bariatric and metabolic procedures: Roux-en-Y gastric bypass, biliopancreatic diversion and duodenal exclusion. We studied 34 patients of both sexes, from outpatient clinics in Surgery of Obesity and the Metabolic Surgery at University of Campinas. They were submitted to bypass gastric in Roux-en-Y (n=15), biliopancreatic diversion (n=9) and duodenal exclusion (n=10). Validated questionnaire for assessment of food tolerance was applied in patients with more than six months of follow-up after surgery addressing diet and gastrointestinal symptoms. The descriptive and comparative analyses were performed by analysis of variance and bivariate correlation. In patients who underwent to bypass gastric food intolerance was greats regarding to ingestion of rice (33%) and red meat (33%) in comparison to others groups. The flatulence and diarrhea were more prevalent in patients who underwent biliopancreatic diversion. The vomiting was more prevalent in patients who underwent gastric bypass. Each procedure presents peculiarities to the anatomical and functional changes that affect the food absorption. This may have negative effects on the nutritional status of patients and affect the quality of life. The nutritional therapy for each individual procedure may assist in the management of clinical concerns of operated patients

Official Title
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Food Tolerance in Patients Submitted to Bariatric Surgery

Conditions
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Bariatric Surgeries

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients submitted of bypass gastric, biliopancreatic diversion and duodenal exclusion Exclusion Criteria: Presenting no diseases that could compromise their nutritional status, such as liver disease, kidney or cancer.

Ages Eligible for Study
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Minimum Age: 24 Years
Maximum Age: 62 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Bypass gastric<br>The mixed surgery which combine the gastric reduction with some degree of disabsorption | |
| Biliopancreatic diversion<br>The mal-absorptive surgery which reduce the intestinal absorption of food | |
| Duodenal exclusion<br>This surgery provides disabsortion by duodenal derivation maintaining an intact stomach | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Food tolerance in patients submitted to bariatric surgery | This study aims to assess habits and food intolerances and gastrointestinal symptoms in patients who underwent bariatric surgery: Roux-en-Y gastric bypass, biliopancreatic diversion and metabolic surgery: duodenal exclusion. | After 1 to 5 years of bariatric surgeries | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Tolerance alimentary, Morbid obesity, Type 2 Diabetes Mellitus