Journal Article

The Effects of One Anastomosis Gastric Bypass Surgery on the Gastrointestinal Tract

Kaniel, Osnat, Khalfin, Boris, Kessler, Yafit, Sherf-Dagan, Shiri, Sakran, Nasser, Moran-Gilad, Jacob, Motro, Yair, Raziel, Asnat, Langer, Peter, Szold, Amir, Goitein, David

2022

Overview

One anastomosis gastric bypass (OAGB) is an emerging bariatric procedure, yet data on its effect on the gastrointestinal tract are lacking. This study sought to evaluate the incidence of small-intestinal bacterial overgrowth (SIBO) following OAGB; explore its effect on nutritional, gastrointestinal, and weight outcomes; and assess post-OABG occurrence of pancreatic exocrine insufficiency (PEI) and altered gut microbiota composition. A prospective pilot cohort study of patients who underwent primary-OAGB surgery is here reported. The pre-surgical and 6-months-post-surgery measurements included anthropometrics, glucose breath-tests, biochemical tests, gastrointestinal symptoms, quality-of-life, dietary intake, and fecal sample collection. Thirty-two patients (50% females, 44.5 ± 12.3 years) participated in this study, and 29 attended the 6-month follow-up visit. The mean excess weight loss at 6 months post-OAGB was 67.8 ± 21.2%. The glucose breath-test was negative in all pre-surgery and positive in 37.0% at 6 months (p = 0.004). Positive glucose breath-test was associated with lower reported dietary intake and folate levels and higher vitamin A deficiency rates (p ≤ 0.036). Fecal elastase-1 test (FE1) was negative for all pre-surgery and positive in 26.1% at 6 months (p = 0.500). Both alpha and beta diversity decreased at 6 months post-surgery compared to pre-surgery (p ≤ 0.026). Relatively high incidences of SIBO and PEI were observed at 6 months post-OAGB, which may explain some gastrointestinal symptoms and nutritional deficiencies.

• Publisher: MDPI AG,MDPI
• Subject: Adult / anthropometric measurements / bariatric surgery / Blind Loop Syndrome - etiology / Body mass index / cohort studies / Diagnostic tests / digestive tract / Exocrine Pancreatic Insufficiency - etiology / Feces / Female / folic acid / food intake / Gastric Bypass - adverse effects / Gastric Bypass - methods / Gastrointestinal Microbiome / Gastrointestinal surgery / gastrointestinal system / Gastrointestinal Tract - microbiology / Gastrointestinal Tract - physiopathology / glucose / Humans / intestinal microorganisms / Intestine, Small - microbiology / Male / Malnutrition - etiology / Microbiota / Middle Aged / Obesity, Morbid - microbiology / Obesity, Morbid - surgery / Pilot Projects / Postoperative Complications - etiology / Prospective Studies / quality of life / Questionnaires / Social research / species diversity / Statistical methods / Treatment Outcome / vitamin A deficiency / Weight Loss