Gastrointestinal complaints after Roux-en-Y gastric bypass surgery. Impact of microbiota and its metabolites
Emma Custers,
Yonta G.R. van der Burgh,
Debby Vreeken,
Frank Schuren,
Tim J. van den Broek,
Lars Verschuren,
Ivo de Blaauw,
Mark Bouwens,
Robert Kleemann,
Amanda J. Kiliaan,
Eric J. Hazebroek
Affiliations
Emma Custers
Department of Bariatric Surgery, Vitalys, Rijnstate Hospital, Arnhem, the Netherlands; Department of Medical Imaging, Anatomy, Radboud University Medical Center, Radboud Alzheimer Center, Donders Institute for Brain Cognition and Behaviour, Center for Medical Neuroscience, Nijmegen, the Netherlands
Yonta G.R. van der Burgh
Department of Bariatric Surgery, Vitalys, Rijnstate Hospital, Arnhem, the Netherlands; Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
Debby Vreeken
Department of Bariatric Surgery, Vitalys, Rijnstate Hospital, Arnhem, the Netherlands; Department of Medical Imaging, Anatomy, Radboud University Medical Center, Radboud Alzheimer Center, Donders Institute for Brain Cognition and Behaviour, Center for Medical Neuroscience, Nijmegen, the Netherlands
Frank Schuren
Department of Metabolic Health Research, The Netherlands Organization for Applied Scientific Research (TNO), Leiden, the Netherlands
Tim J. van den Broek
Department of Metabolic Health Research, The Netherlands Organization for Applied Scientific Research (TNO), Leiden, the Netherlands
Lars Verschuren
Department of Metabolic Health Research, The Netherlands Organization for Applied Scientific Research (TNO), Leiden, the Netherlands
Ivo de Blaauw
Department of Surgery, Division of Paediatric Surgery, Radboudumc-Amalia Children's Hospital, Nijmegen, the Netherlands
Mark Bouwens
Dutch Digestive Foundation, Amersfoort, the Netherlands
Robert Kleemann
Department of Metabolic Health Research, The Netherlands Organization for Applied Scientific Research (TNO), Leiden, the Netherlands
Amanda J. Kiliaan
Department of Medical Imaging, Anatomy, Radboud University Medical Center, Radboud Alzheimer Center, Donders Institute for Brain Cognition and Behaviour, Center for Medical Neuroscience, Nijmegen, the Netherlands; Corresponding author. Dept Medical Imaging, Anatomy, Donders Institute for Brain, Cognition, and Behavior, Chair Preclinical Imaging Center PRIME, Radboud university medical center, Geert Grooteplein, 21N 6525 EZ, Nijmegen, NL, the Netherlands.
Eric J. Hazebroek
Department of Bariatric Surgery, Vitalys, Rijnstate Hospital, Arnhem, the Netherlands; Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
Unexplainable gastrointestinal complaints occasionally occur after Roux-en-Y Gastric Bypass (RYGB) surgery. We therefor investigated the impact of microbiota composition and metabolites on gastrointestinal complaints after RYGB. In the BARICO study (Bariatric surgery Rijnstate and Radboudumc neuroimaging and Cognition in Obesity), microbiota and metabolites were measured before surgery, and 6, and 24 months after surgery. Gastrointestinal complaints were assessed with the Irritable Bowel Syndrome Severity Scoring System (IBS-SSS) questionnaire 24 months after surgery. 65 participants (86.2 % female) with a mean age of 46.2 ± 6.0 years, and mean BMI of 41.2 ± 3.6 kg/m2 were included. According to the IBS-SSS questionnaire, 32.3 % had moderate/severe gastrointestinal complaints 24 months after surgery. Microbiota alpha diversity remained stable, while beta diversity significantly changed over time. Bile acids and short-chain fatty acids were significantly higher, and inflammatory markers significantly lower after surgery. Barnesiella sp., Escherichia/Shigella sp., and Faecalibacterium prausnitzii correlated positively, while Akkermansia sp correlated inversely with gastrointestinal complaints. Patients with mild and moderate/severe gastrointestinal complaints showed higher levels of GLC-3S. These findings suggest involvement of microbiota and metabolite changes in gastrointestinal complaints after surgery. However, it remains unclear whether bacteria influence gastrointestinal complaints directly or indirectly. Further exploration is required for development of interventions against gastrointestinal symptoms after surgery.
