Assessment of Gastric Remnant Activity, Symptoms, and Quality of Life Following Gastric Bypass
Introduction While most gastric bypass patients recover well, some experience long-term complications, including nausea, abdominal pain, food intolerance, and dumping. This study aimed to evaluate symptoms and quality of life (QoL) in association with the residual activity of the remnant stomach. Me...
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| Veröffentlicht in: | Obesity surgery 2024-12, Vol.34 (12), p.4490-4498 |
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| creator | Wang, Tim Hsu-Han Varghese, Chris Calder, Stefan Gharibans, Armen A. Evennett, Nicholas Beban, Grant Schamberg, Gabriel O’Grady, Greg |
| description | Introduction
While most gastric bypass patients recover well, some experience long-term complications, including nausea, abdominal pain, food intolerance, and dumping. This study aimed to evaluate symptoms and quality of life (QoL) in association with the residual activity of the remnant stomach.
Methods
Patients undergoing gastric bypass and conversion-to-bypass were recruited. The Gastric Alimetry® System (Auckland, NZ) was employed, comprising a high-resolution electrode array, wearable reader, and validated symptom logging app. The protocol comprised 30-min fasting baseline, a 218-kCal meal stimulus, and 4-h of post-prandial recordings. Symptoms and QoL were evaluated using validated questionnaires. Remnant gastric electrophysiology evaluation included frequency, BMI-adjusted amplitude, and Gastric Alimetry Rhythm Index (GA-RI, reflecting pacemaker stability), with comparison to validated reference intervals and matched controls.
Results
Thirty-eight participants were recruited with mean time from bypass 46.8 ± 28.6 months. One-third of patients showed moderate to severe post-prandial symptoms, with patients’ median PAGI-SYM 28 ± 19 vs controls 9 ± 17 (
p
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| doi_str_mv | 10.1007/s11695-024-07534-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11671428</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3149315910</sourcerecordid><originalsourceid>FETCH-LOGICAL-c356t-aa213390b774d6052acd5071864678be3eb3ca608a45baafea514648b3e2947f3</originalsourceid><addsrcrecordid>eNp9kU1v1DAQhi0EokvhD3BAkbj00NDxd3xCS0UL0koVX1esSdZZUiXx4kla7b_HZcvyceBkaeaZ1_POy9hzDq84gD0jzo3TJQhVgtVSlfoBW3ALVQlKVA_ZApyBsnJCHrEnRNcAghshHrMj6aSzAtyCfV0SBaIhjFMR2-ISaUpdU3wMw4i5tGym7qabdqfFp92wneJApwWO6-LDjH0u342sujYUF7Hv4203bg4Kb3ZbJHrKHrXYU3h2_x6zLxdvP5-_K1dXl-_Pl6uykdpMJaLgUjqorVVrA1pgs9ZgeWWUsVUdZKhlgwYqVLpGbANqroyqahmEU7aVx-z1Xnc710NYN9lOwt5vUzdg2vmInf-7M3bf_Cbe-HxCy_O1ssLJvUKK3-dAkx86akLf4xjiTF5mUkqjrcroy3_Q6zinMfvLlHKSa8chU2JPNSkSpdAetuHg7_Lz-_x8zs__zM_rPPTiTx-HkV-BZUDuAcqtcRPS77__I_sDJuOmKg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3149315910</pqid></control><display><type>article</type><title>Assessment of Gastric Remnant Activity, Symptoms, and Quality of Life Following Gastric Bypass</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Wang, Tim Hsu-Han ; Varghese, Chris ; Calder, Stefan ; Gharibans, Armen A. ; Evennett, Nicholas ; Beban, Grant ; Schamberg, Gabriel ; O’Grady, Greg</creator><creatorcontrib>Wang, Tim Hsu-Han ; Varghese, Chris ; Calder, Stefan ; Gharibans, Armen A. ; Evennett, Nicholas ; Beban, Grant ; Schamberg, Gabriel ; O’Grady, Greg</creatorcontrib><description>Introduction
While most gastric bypass patients recover well, some experience long-term complications, including nausea, abdominal pain, food intolerance, and dumping. This study aimed to evaluate symptoms and quality of life (QoL) in association with the residual activity of the remnant stomach.
Methods
Patients undergoing gastric bypass and conversion-to-bypass were recruited. The Gastric Alimetry® System (Auckland, NZ) was employed, comprising a high-resolution electrode array, wearable reader, and validated symptom logging app. The protocol comprised 30-min fasting baseline, a 218-kCal meal stimulus, and 4-h of post-prandial recordings. Symptoms and QoL were evaluated using validated questionnaires. Remnant gastric electrophysiology evaluation included frequency, BMI-adjusted amplitude, and Gastric Alimetry Rhythm Index (GA-RI, reflecting pacemaker stability), with comparison to validated reference intervals and matched controls.
Results
Thirty-eight participants were recruited with mean time from bypass 46.8 ± 28.6 months. One-third of patients showed moderate to severe post-prandial symptoms, with patients’ median PAGI-SYM 28 ± 19 vs controls 9 ± 17 (
p
< 0.01); PAGI-QOL 37 ± 31 vs 135 ± 22 (
p
< 0.0001). Remnant gastric function was markedly degraded shown by undetectable frequencies in 84% (vs 0% in controls) and low GA-RI (0.18 ± 0.08 vs 0.51 ± 0.22 in controls;
p
< 0.0001; reference range > 0.25). Impaired GA-RI and amplitude were correlated with worse PAGI-SYM and PAGI-QOL scores.
Conclusion
One-third of post-bypass patients suffered significant upper GI symptoms with reduced QoL. The bypassed remnant stomach shows highly deranged electrophysiology in-situ, reflecting disuse degeneration. These derangements correlated with QoL; however, causality is not implied by the present study.</description><identifier>ISSN: 0960-8923</identifier><identifier>ISSN: 1708-0428</identifier><identifier>EISSN: 1708-0428</identifier><identifier>DOI: 10.1007/s11695-024-07534-5</identifier><identifier>PMID: 39397209</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Pain - etiology ; Adult ; Dumping Syndrome - etiology ; Dumping Syndrome - physiopathology ; Female ; Gastric Bypass ; Gastric Emptying - physiology ; Gastric Stump ; Gastrointestinal surgery ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Nausea - etiology ; Nausea - physiopathology ; Obesity, Morbid - physiopathology ; Obesity, Morbid - psychology ; Obesity, Morbid - surgery ; Postoperative Complications ; Postprandial Period ; Quality of Life ; Surgery ; Surveys and Questionnaires</subject><ispartof>Obesity surgery, 2024-12, Vol.34 (12), p.4490-4498</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><rights>Copyright Springer Nature B.V. Dec 2024</rights><rights>The Author(s) 2024 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c356t-aa213390b774d6052acd5071864678be3eb3ca608a45baafea514648b3e2947f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11695-024-07534-5$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11695-024-07534-5$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39397209$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Tim Hsu-Han</creatorcontrib><creatorcontrib>Varghese, Chris</creatorcontrib><creatorcontrib>Calder, Stefan</creatorcontrib><creatorcontrib>Gharibans, Armen A.</creatorcontrib><creatorcontrib>Evennett, Nicholas</creatorcontrib><creatorcontrib>Beban, Grant</creatorcontrib><creatorcontrib>Schamberg, Gabriel</creatorcontrib><creatorcontrib>O’Grady, Greg</creatorcontrib><title>Assessment of Gastric Remnant Activity, Symptoms, and Quality of Life Following Gastric Bypass</title><title>Obesity surgery</title><addtitle>OBES SURG</addtitle><addtitle>Obes Surg</addtitle><description>Introduction
While most gastric bypass patients recover well, some experience long-term complications, including nausea, abdominal pain, food intolerance, and dumping. This study aimed to evaluate symptoms and quality of life (QoL) in association with the residual activity of the remnant stomach.
Methods
Patients undergoing gastric bypass and conversion-to-bypass were recruited. The Gastric Alimetry® System (Auckland, NZ) was employed, comprising a high-resolution electrode array, wearable reader, and validated symptom logging app. The protocol comprised 30-min fasting baseline, a 218-kCal meal stimulus, and 4-h of post-prandial recordings. Symptoms and QoL were evaluated using validated questionnaires. Remnant gastric electrophysiology evaluation included frequency, BMI-adjusted amplitude, and Gastric Alimetry Rhythm Index (GA-RI, reflecting pacemaker stability), with comparison to validated reference intervals and matched controls.
Results
Thirty-eight participants were recruited with mean time from bypass 46.8 ± 28.6 months. One-third of patients showed moderate to severe post-prandial symptoms, with patients’ median PAGI-SYM 28 ± 19 vs controls 9 ± 17 (
p
< 0.01); PAGI-QOL 37 ± 31 vs 135 ± 22 (
p
< 0.0001). Remnant gastric function was markedly degraded shown by undetectable frequencies in 84% (vs 0% in controls) and low GA-RI (0.18 ± 0.08 vs 0.51 ± 0.22 in controls;
p
< 0.0001; reference range > 0.25). Impaired GA-RI and amplitude were correlated with worse PAGI-SYM and PAGI-QOL scores.
Conclusion
One-third of post-bypass patients suffered significant upper GI symptoms with reduced QoL. The bypassed remnant stomach shows highly deranged electrophysiology in-situ, reflecting disuse degeneration. These derangements correlated with QoL; however, causality is not implied by the present study.</description><subject>Abdominal Pain - etiology</subject><subject>Adult</subject><subject>Dumping Syndrome - etiology</subject><subject>Dumping Syndrome - physiopathology</subject><subject>Female</subject><subject>Gastric Bypass</subject><subject>Gastric Emptying - physiology</subject><subject>Gastric Stump</subject><subject>Gastrointestinal surgery</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Nausea - etiology</subject><subject>Nausea - physiopathology</subject><subject>Obesity, Morbid - physiopathology</subject><subject>Obesity, Morbid - psychology</subject><subject>Obesity, Morbid - surgery</subject><subject>Postoperative Complications</subject><subject>Postprandial Period</subject><subject>Quality of Life</subject><subject>Surgery</subject><subject>Surveys and Questionnaires</subject><issn>0960-8923</issn><issn>1708-0428</issn><issn>1708-0428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9kU1v1DAQhi0EokvhD3BAkbj00NDxd3xCS0UL0koVX1esSdZZUiXx4kla7b_HZcvyceBkaeaZ1_POy9hzDq84gD0jzo3TJQhVgtVSlfoBW3ALVQlKVA_ZApyBsnJCHrEnRNcAghshHrMj6aSzAtyCfV0SBaIhjFMR2-ISaUpdU3wMw4i5tGym7qabdqfFp92wneJApwWO6-LDjH0u342sujYUF7Hv4203bg4Kb3ZbJHrKHrXYU3h2_x6zLxdvP5-_K1dXl-_Pl6uykdpMJaLgUjqorVVrA1pgs9ZgeWWUsVUdZKhlgwYqVLpGbANqroyqahmEU7aVx-z1Xnc710NYN9lOwt5vUzdg2vmInf-7M3bf_Cbe-HxCy_O1ssLJvUKK3-dAkx86akLf4xjiTF5mUkqjrcroy3_Q6zinMfvLlHKSa8chU2JPNSkSpdAetuHg7_Lz-_x8zs__zM_rPPTiTx-HkV-BZUDuAcqtcRPS77__I_sDJuOmKg</recordid><startdate>202412</startdate><enddate>202412</enddate><creator>Wang, Tim Hsu-Han</creator><creator>Varghese, Chris</creator><creator>Calder, Stefan</creator><creator>Gharibans, Armen A.</creator><creator>Evennett, Nicholas</creator><creator>Beban, Grant</creator><creator>Schamberg, Gabriel</creator><creator>O’Grady, Greg</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>202412</creationdate><title>Assessment of Gastric Remnant Activity, Symptoms, and Quality of Life Following Gastric Bypass</title><author>Wang, Tim Hsu-Han ; Varghese, Chris ; Calder, Stefan ; Gharibans, Armen A. ; Evennett, Nicholas ; Beban, Grant ; Schamberg, Gabriel ; O’Grady, Greg</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-aa213390b774d6052acd5071864678be3eb3ca608a45baafea514648b3e2947f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Abdominal Pain - etiology</topic><topic>Adult</topic><topic>Dumping Syndrome - etiology</topic><topic>Dumping Syndrome - physiopathology</topic><topic>Female</topic><topic>Gastric Bypass</topic><topic>Gastric Emptying - physiology</topic><topic>Gastric Stump</topic><topic>Gastrointestinal surgery</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Nausea - etiology</topic><topic>Nausea - physiopathology</topic><topic>Obesity, Morbid - physiopathology</topic><topic>Obesity, Morbid - psychology</topic><topic>Obesity, Morbid - surgery</topic><topic>Postoperative Complications</topic><topic>Postprandial Period</topic><topic>Quality of Life</topic><topic>Surgery</topic><topic>Surveys and Questionnaires</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Tim Hsu-Han</creatorcontrib><creatorcontrib>Varghese, Chris</creatorcontrib><creatorcontrib>Calder, Stefan</creatorcontrib><creatorcontrib>Gharibans, Armen A.</creatorcontrib><creatorcontrib>Evennett, Nicholas</creatorcontrib><creatorcontrib>Beban, Grant</creatorcontrib><creatorcontrib>Schamberg, Gabriel</creatorcontrib><creatorcontrib>O’Grady, Greg</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Obesity surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Tim Hsu-Han</au><au>Varghese, Chris</au><au>Calder, Stefan</au><au>Gharibans, Armen A.</au><au>Evennett, Nicholas</au><au>Beban, Grant</au><au>Schamberg, Gabriel</au><au>O’Grady, Greg</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessment of Gastric Remnant Activity, Symptoms, and Quality of Life Following Gastric Bypass</atitle><jtitle>Obesity surgery</jtitle><stitle>OBES SURG</stitle><addtitle>Obes Surg</addtitle><date>2024-12</date><risdate>2024</risdate><volume>34</volume><issue>12</issue><spage>4490</spage><epage>4498</epage><pages>4490-4498</pages><issn>0960-8923</issn><issn>1708-0428</issn><eissn>1708-0428</eissn><abstract>Introduction
While most gastric bypass patients recover well, some experience long-term complications, including nausea, abdominal pain, food intolerance, and dumping. This study aimed to evaluate symptoms and quality of life (QoL) in association with the residual activity of the remnant stomach.
Methods
Patients undergoing gastric bypass and conversion-to-bypass were recruited. The Gastric Alimetry® System (Auckland, NZ) was employed, comprising a high-resolution electrode array, wearable reader, and validated symptom logging app. The protocol comprised 30-min fasting baseline, a 218-kCal meal stimulus, and 4-h of post-prandial recordings. Symptoms and QoL were evaluated using validated questionnaires. Remnant gastric electrophysiology evaluation included frequency, BMI-adjusted amplitude, and Gastric Alimetry Rhythm Index (GA-RI, reflecting pacemaker stability), with comparison to validated reference intervals and matched controls.
Results
Thirty-eight participants were recruited with mean time from bypass 46.8 ± 28.6 months. One-third of patients showed moderate to severe post-prandial symptoms, with patients’ median PAGI-SYM 28 ± 19 vs controls 9 ± 17 (
p
< 0.01); PAGI-QOL 37 ± 31 vs 135 ± 22 (
p
< 0.0001). Remnant gastric function was markedly degraded shown by undetectable frequencies in 84% (vs 0% in controls) and low GA-RI (0.18 ± 0.08 vs 0.51 ± 0.22 in controls;
p
< 0.0001; reference range > 0.25). Impaired GA-RI and amplitude were correlated with worse PAGI-SYM and PAGI-QOL scores.
Conclusion
One-third of post-bypass patients suffered significant upper GI symptoms with reduced QoL. The bypassed remnant stomach shows highly deranged electrophysiology in-situ, reflecting disuse degeneration. These derangements correlated with QoL; however, causality is not implied by the present study.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>39397209</pmid><doi>10.1007/s11695-024-07534-5</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Obesity surgery, 2024-12, Vol.34 (12), p.4490-4498 |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Abdominal Pain - etiology Adult Dumping Syndrome - etiology Dumping Syndrome - physiopathology Female Gastric Bypass Gastric Emptying - physiology Gastric Stump Gastrointestinal surgery Humans Male Medicine Medicine & Public Health Middle Aged Nausea - etiology Nausea - physiopathology Obesity, Morbid - physiopathology Obesity, Morbid - psychology Obesity, Morbid - surgery Postoperative Complications Postprandial Period Quality of Life Surgery Surveys and Questionnaires |
| title | Assessment of Gastric Remnant Activity, Symptoms, and Quality of Life Following Gastric Bypass |
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