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Irritable bowel syndrome-like symptoms before and after bariatric surgery and association with short-chain fermentable carbohydrates consumption: an observational prospective study

Journal Volume 86 - 2023
Issue Fasc.2 - Original articles
Author(s) P. Van Ouytsel 1 2, H. Piessevaux 3, A. Szalai 1, P. Loi 4, H. Louis 2
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Full Article
PAGES 288-297
(1) Department of Dietetics, HUB - CUB Hôpital Erasme (ULB), Brussels, Belgium
(2) Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, HUB - CUB Hôpital Erasme (ULB), Brussels, Belgium
(3) Department of Hepato-Gastroenterology, Cliniques universitaires Saint-Luc (UCLouvain), Brussels, Belgium
(4) Department of Digestive Surgery, HUB - CUB Hôpital Erasme (ULB), Brussels, Belgium

Background and aims: Irritable Bowel Syndrome (IBS)-like symptoms are frequent following bariatric surgery. This study aims to evaluate the frequency of IBS symptoms severity before and after bariatric surgery and their association with short-chain fermentable carbohydrates (FODMAPs) consumption.

Patients and methods: IBS symptoms severity in a cohort of obese patients was evaluated prospectively before, 6 and 12 months after bariatric surgery by validated questionnaires and tools (Irritable Bowel Syndrome Severity Scoring System (IBS SSS), Bristol Stool Scale (BSS), Quality of Life Short- Form-12 (SF-12), Hospital Anxiety and Depression scale (HAD)). FODMAPs consumption and its association with IBS symptom severity was evaluated by using a food frequency questionnaire focused on high-FODMAPs food consumption.

Results: Fifty-one patients were included (41 female; mean age 41 years (SD: 12)), 84% received a sleeve gastrectomy, and 16% a Roux-en-Y gastric bypass. Symptoms compatible with IBS were observed in 43% of patients before surgery, in 58% of patients at 6 months and 33% at 12 months (NS, p-value=0,197 and 0,414). In a multivariate model, a significant association was found between the IBS SSS score and lactose consumption at 6 months (β = + 58, 1; p = 0.03), and with polyols consumption at 12 months (β = + 112,6; p = 0.01).

Conclusions: Mild to moderate IBS symptoms are frequent in obese patients before bariatric surgery. A significant association between lactose and polyols consumption and IBS SSS score was observed after bariatric surgery, suggesting a potential link between the severity of IBS symptoms and some specific FODMAPs consumption.

Keywords: IBS, FODMAPs, bariatric surgery, obesity.

The authors declare that they have no conflict of interest.
© Acta Gastro-Enterologica Belgica.
PMID 37428161