Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Medicinerhuset 4th floor, Mølleparkvej 4, DK-9000, Aalborg, Denmark.
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Obes Surg. 2021 Jun;31(6):2632-2640. doi: 10.1007/s11695-021-05308-x. Epub 2021 Mar 12.
Studies investigating the underlying pathophysiology are needed to help explain and understand the postoperative complications following Roux-en-Y gastric bypass (RYGB) surgery. This study aimed to characterize segmental gastrointestinal pH profiles, motility measures, and transit times in patients with RYGB.
Nineteen patients with RYGB underwent a standardized wireless motility capsule assessment. The oro-cecal segment was defined from capsule ingestion until the passage of the ileocecal junction. Segmental median pH, motility index, and transit time were determined for the oro-cecal and colonic segment as well as for the first and last hour of both these segments. For comparison to reference values, data from 17 healthy age- and gender-matched controls was used. A mixed effect model was used to describe differences between groups.
Median pH was high in patients with RYGB during the first hour of the oro-cecal segment (6.45 ± 0.4 vs 3.65 ± 1.55 pH units for healthy controls; P < 0.001), as well as during the entire oro-cecal segment (6.97 ± 0.4 vs 5.51 ± 1.1 pH units; P < 0.001). The same was evident for the median motility index (152 ± 64 vs 35.8 ± 31.1 mmHgsec/min; P < 0.001 and 130 ± 65.9 vs 89.1 ± 20 mmHgsec/min; P < 0.012, respectively). Median motility index was low the first hour of the colon (55.2 ± 45.7 vs 122 ± 77.9 mmHg*sec/min; P < 0.002). Additionally, patients had short oro-cecal transit time (5.8 ± 1.6 vs 7.6 ± 1.4 h; P < 0.001) and long colonic transit time (29.4 ± 17.5 vs 19.6 ± 12.2 h; P = 0.048).
In patients with RYGB, the oro-cecal segment was characterized by an alkaline intraluminal environment, high motility activity, and short transit time. In contrast, colonic transit time was long.
需要研究潜在的病理生理学，以帮助解释和理解 Roux-en-Y 胃旁路（RYGB）手术后的并发症。本研究旨在描述 RYGB 患者的胃肠道节段 pH 谱、运动测量和通过时间。
19 例 RYGB 患者接受了标准化的无线动力胶囊评估。从胶囊摄入到回盲瓣通过，将口-盲肠段定义为口-盲肠段。确定口-盲肠段和结肠段的节段中位数 pH、运动指数和通过时间，以及这两个节段的前 1 小时和最后 1 小时。为了与参考值进行比较，使用了 17 名年龄和性别匹配的健康对照者的数据。使用混合效应模型描述组间差异。
在 RYGB 患者中，口-盲肠段的第 1 小时 pH 值较高（6.45 ± 0.4 与健康对照组的 3.65 ± 1.55 pH 单位相比；P < 0.001），整个口-盲肠段也是如此（6.97 ± 0.4 与 5.51 ± 1.1 pH 单位相比；P < 0.001）。中位数运动指数也是如此（152 ± 64 与 35.8 ± 31.1 mmHgsec/min；P < 0.001 和 130 ± 65.9 与 89.1 ± 20 mmHgsec/min；P < 0.012，分别）。结肠的第 1 小时运动指数较低（55.2 ± 45.7 与 122 ± 77.9 mmHg*sec/min；P < 0.002）。此外，患者的口-盲肠通过时间较短（5.8 ± 1.6 与 7.6 ± 1.4 h；P < 0.001），结肠通过时间较长（29.4 ± 17.5 与 19.6 ± 12.2 h；P = 0.048）。
在 RYGB 患者中，口-盲肠段的特点是腔内环境呈碱性、运动活性高、通过时间短。相比之下，结肠通过时间较长。
