GI Symptoms in Obese Patients and Bariatric Surgery Outcomes
GI Symptoms in Obese Patients and Bariatric Surgery Outcomes
Obesity is considered an important risk factor for the development of GI symptoms, in particular GERD, most likely through alterations of GI motility and sensitivity. Available data are still conflicting and bias is likely to be ascribed to different diagnostic criteria, different follow-up duration and mainly to multiple morbid obesity-related comorbidities. Even if data are contrasting, several GI symptoms occurring after bariatric surgery are probably underestimated, as these patients are not frequently referred to GI outpatient clinics. A specialized clinical management would be desirable to establish tailored management. The complexity of these patients, before and after bariatric surgery, require multidisciplinary management that includes a gastroenterologist who can help in the preoperative and postoperative management of morbid obese patients.
To have a better management of these patients, it would be important to categorize them using Rome III criteria for functional symptoms, after exclusion of organic diseases. Furthermore, to clarify the different perturbations inherent to each bariatric procedure and their possible complications, accurate diagnostic secretory and/or motility testing as well as morphologic imaging are particularly needed after LSG.
Discussion
Obesity is considered an important risk factor for the development of GI symptoms, in particular GERD, most likely through alterations of GI motility and sensitivity. Available data are still conflicting and bias is likely to be ascribed to different diagnostic criteria, different follow-up duration and mainly to multiple morbid obesity-related comorbidities. Even if data are contrasting, several GI symptoms occurring after bariatric surgery are probably underestimated, as these patients are not frequently referred to GI outpatient clinics. A specialized clinical management would be desirable to establish tailored management. The complexity of these patients, before and after bariatric surgery, require multidisciplinary management that includes a gastroenterologist who can help in the preoperative and postoperative management of morbid obese patients.
To have a better management of these patients, it would be important to categorize them using Rome III criteria for functional symptoms, after exclusion of organic diseases. Furthermore, to clarify the different perturbations inherent to each bariatric procedure and their possible complications, accurate diagnostic secretory and/or motility testing as well as morphologic imaging are particularly needed after LSG.
