Food tolerance and gastrointestinal quality of life following three bariatric procedures: adjustable gastric banding, Roux-en-Y gastric bypass, and sleeve gastrectomy

Abstract

Background: To investigate and compare food tolerance and gastrointestinal quality of life following three bariatric procedures approximately 2 to 4 years post-surgery: adjustable gastric banding (AGB), Roux-en-Y gastric bypass (RYGBP), and sleeve gastrectomy (SG). A secondary aim was to test for a relationship between food tolerance and gastrointestinal quality of life.

Methods: In this prospective cross-sectional study, participants (including pre-surgery controls) completed two questionnaires: a food tolerance questionnaire (n = 129) and a Gastrointestinal Quality of Life Index (GIQLI) (n = 119). Kruskal-Wallis and Mann-Whitney tests were performed, and significance was adjusted using a post-hoc Bonferroni correction. Spearman's rank correlation coefficients were calculated to evaluate the relationship between food tolerance and GIQLI scores.

Results: Food tolerance: the control and SG groups produced the highest median scores (24.5 and 24.0, respectively), indicating superior food tolerance. The median score of the AGB group was significantly lower than all other groups (15.5, P < 0.001). Gastrointestinal quality of life: the SG group ranked superior, producing the highest median score (120.5), which was significantly greater than the AGB (94.0, P = 0.005) and control groups (96.0, P = 0.006). GIQLI scores correlated significantly with food tolerance scores (r = 0.522, P < 0.01). The median excess weight loss was similar in the SG and RYGBP groups (76.3% and 76.5%), with the AGB group significantly lower at 38.2%.

Conclusions: Food tolerance and gastrointestinal quality of life, 2 to 4 years post-surgery are ostensibly best after SG, followed closely by RYGBP. AGB appears the least effective across these parameters. A significant positive relationship between food tolerance and gastrointestinal quality of life was confirmed.