Boerlage T C C, van de Laar A W J M, Westerlaken S, Gerdes V E A, Brandjes D P M
Departments of Internal Medicine, Academic Medical Centre, Amsterdam, The Netherlands.
Departments of Surgery, Academic Medical Centre, Amsterdam, The Netherlands.
Br J Surg. 2017 Mar;104(4):393-400. doi: 10.1002/bjs.10419. Epub 2016 Dec 19.
Laparoscopic Roux-en-Y gastric bypass (LRYGB) is an effective treatment for morbid obesity, but might aggravate gastrointestinal complaints and food intolerance. The long-term prevalence of these symptoms has not been well studied.
In a cross-sectional study, all patients who underwent primary LRYGB from May to October 2012 were approached 2 years after surgery to complete a general health questionnaire, the Gastrointestinal Symptom Rating Scale (GSRS), and a food intolerance questionnaire. The results were compared with those for a control group of morbidly obese patients.
A total of 249 patients were included for analysis, representing a response rate of 93·9 per cent. Mean(s.d.) total weight loss was 30·8(8·7) per cent. The total mean GSRS score was higher in patients who had LRYGB (median 2·19 versus 1·75 in unoperated patients; P < 0·001); the difference in symptoms of indigestion was most notable (P < 0·001). Food intolerance for specific products was reported by 70·7 (95 per cent c.i. 64·8 to 76·0) per cent of the postoperative patients, for a median of 4 foods. There was a positive correlation between food intolerance and score on the GSRS. There was no correlation between either food intolerance or the total mean GSRS score and weight loss, but there was a correlation between weight loss and abdominal pain.
At 2 years after surgery, patients undergoing LRYGB for morbid obesity have more gastrointestinal complaints than obese controls. Food intolerance is a common side-effect of LRYGB independent of degree of weight loss or the presence of other abdominal symptoms.
腹腔镜Roux-en-Y胃旁路术（LRYGB）是治疗病态肥胖的有效方法，但可能会加重胃肠道不适和食物不耐受。这些症状的长期患病率尚未得到充分研究。
在一项横断面研究中，对2012年5月至10月接受初次LRYGB手术的所有患者在术后2年进行随访，让他们完成一份一般健康问卷、胃肠道症状评分量表（GSRS）和一份食物不耐受问卷。将结果与病态肥胖患者对照组的结果进行比较。
共纳入249例患者进行分析，应答率为93.9%。平均（标准差）体重减轻30.8（8.7）%。接受LRYGB手术的患者GSRS总分平均值更高（中位数2.19，未手术患者为1.75；P＜0.001）；消化不良症状的差异最为显著（P＜0.001）。70.7%（95%置信区间64.8%至76.0%）的术后患者报告对特定产品存在食物不耐受，中位数为4种食物。食物不耐受与GSRS评分之间存在正相关。食物不耐受或GSRS总平均分与体重减轻之间均无相关性，但体重减轻与腹痛之间存在相关性。
术后2年，接受LRYGB治疗病态肥胖的患者比肥胖对照组有更多的胃肠道不适。食物不耐受是LRYGB常见的副作用，与体重减轻程度或其他腹部症状无关。
