Mucosal and hormonal adaptations after Roux-en-Y gastric bypass

The aim of this study was to perform a comprehensive literature review regarding the relevant hor-monal and histologic changes observed after Roux-en-Y gastric bypass (RYGB). We aimed to describe the relevant hormonal (glucagon-like peptides 1 and 2 [GLP-1 and GLP-2], peptide YY [PYY], oxyntomodulin [OXM], bile acids [BA], cholecystokinin [CCK], ghrelin, glucagon, gastric inhibitory polypeptide [GIP], and amylin) profiles, as well as the histologic (mucosal cellular) adap-tations happening after patients undergo RYGB. Our review compiles the current evidence and fur-thers the understanding of the rationale behind the food intake regulatory adaptations occurring after RYGB surgery. We identify gaps in the literature where the potential for future investigations and therapeutics may lie. We performed a comprehensive database search without language restrictions looking for RYGB bariatric surgery outcomes in patients with pre-and postoperative blood work hor-monal profiling and/or gut mucosal biopsies. We gathered the relevant study results and describe them in this review. Where human findings were lacking, we included animal model studies. The amalgam-ation of physiologic, metabolic, and cellular adaptations following RYGB is yet to be fully charac-terized. This constitutes a fundamental aspiration for enhancing and individualizing obesity therapy. (Surg Obes Relat Dis 2023;19:37-49.) (c) 2023 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Automated summary

The aim of this study was to review the hormonal and histologic changes observed after RYGB surgery, and to identify gaps and future research directions. The study provides a comprehensive understanding of the food intake regulatory adaptations occurring after RYGB surgery.