Prevalence and Factors Associated With Symptom Profiles of Disorders of Gut-Brain Interaction in Obesity Before and After Treatment.

BACKGROUND & AIMS: Disorders of gut-brain interaction (DGBI) in obesity could impair health outcomes. Therefore, we aimed to study the prevalence and burden of symptoms compatible with a DGBI in obesity and assess the effect of obesity treatment on comorbid DGBI.

METHODS

We used baseline and two-year follow-up data from a prospective non-randomized cohort study including patients with obesity referred for obesity treatment. Patients completed the Rome III questionnaire before and after receiving Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), or medical treatment. Validated questionnaires and blood parameters were used to assess the burden of DGBI in obesity.

RESULTS

In total, 939 patients (73% female, 44 ± 13 years, 42 ± 5 kg/m2, 36% medical treatment, 38% RYGB, 20% SG) completed the Rome III questionnaire at baseline and 651 patients (32 ± 6 kg/m2) at follow-up. The proportion of patients with a DGBI symptom profile was reduced from 61% (24% esophageal, 27% gastroduodenal, 38% bowel, and 8% anorectal disorders) to 53% (15% esophageal, 25% gastroduodenal, 34% bowel, 8% anorectal disorders) at follow-up. There was a substantial shift between the baseline and follow-up DGBI symptom profiles across all GI regions. Patients with a DGBI symptom profile at baseline presented with more severe psychological distress, a poorer quality of life, and were more likely to be female.

CONCLUSIONS

DGBI symptom profiles are common and can impair health outcomes in obesity. Obesity treatment lowers the prevalence of DGBI symptoms in general, but an important shift between baseline and follow-up DGBI symptom profiles across all GI regions can be observed.