Gastrointestinal symptoms and food intolerance 2 years after laparoscopic Roux-en-Y gastric bypass for morbid obesity

Background: 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. Methods: 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. Results: 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. Conclusion: 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.