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

Abstract

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.