HYPOTHESIS: Following weight loss surgery, many patients initially experience nonspecific foregut symptoms. Helicobacter pylori infection of the gastric remnant may be associated with foregut symptoms. DESIGN: Inception cohort. SETTING: University hospital. PATIENTS: Ninety-nine consecutive patients being evaluated for weight loss surgery. INTERVENTION: All patients underwent preoperative esophagogastroduodenoscopy and H pylori testing. MAIN OUTCOME MEASURES: Foregut symptoms were documented at routine post-weight loss surgery follow-up visits. RESULTS: Preoperatively, 24% of patients tested positive for H pylori. Postoperative foregut symptoms were significant in 48% of the H pylori-positive group, and 19% of the H pylori-negative group (P = .02). This increase remained even after controlling for age, sex, preoperative presence of antritis, type of surgery performed, and body mass index (odds ratio, 3.6; 95% confidence interval,1.1-11.8). Patients with prolonged symptoms who tested positive for H pylori were given an eradication treatment. CONCLUSIONS: The prevalence of H pylori infection in patients undergoing weight loss surgery is high, and a significant proportion of them have postoperative foregut symptoms. Consideration should be given to H pylori treatment in these patients.
HYPOTHESIS: Following weight loss surgery, many patients initially experience nonspecific foregut symptoms. Helicobacter pyloriinfection of the gastric remnant may be associated with foregut symptoms. DESIGN: Inception cohort. SETTING: University hospital. PATIENTS: Ninety-nine consecutive patients being evaluated for weight loss surgery. INTERVENTION: All patients underwent preoperative esophagogastroduodenoscopy and H pylori testing. MAIN OUTCOME MEASURES: Foregut symptoms were documented at routine post-weight loss surgery follow-up visits. RESULTS: Preoperatively, 24% of patients tested positive for H pylori. Postoperative foregut symptoms were significant in 48% of the H pylori-positive group, and 19% of the H pylori-negative group (P = .02). This increase remained even after controlling for age, sex, preoperative presence of antritis, type of surgery performed, and body mass index (odds ratio, 3.6; 95% confidence interval,1.1-11.8). Patients with prolonged symptoms who tested positive for H pylori were given an eradication treatment. CONCLUSIONS: The prevalence of H pylori infection in patients undergoing weight loss surgery is high, and a significant proportion of them have postoperative foregut symptoms. Consideration should be given to H pylori treatment in these patients.
Authors: Usha K Coblijn; Amin B Goucham; Sjoerd M Lagarde; Sjoerd D Kuiken; Bart A van Wagensveld Journal: Obes Surg Date: 2014-02 Impact factor: 4.129