Gastrointestinal changes after bariatric surgery - 16/04/14

Doi : 10.1016/j.diabet.2013.11.003

I. Quercia ^a,^d, R. Dutia ^a,^d, D.P. Kotler ^c,^d,^f, S. Belsley ^e,^f, B. Laferrère ^a,^b,^d,^f,^⁎
^a New York Obesity Nutrition Research Center, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, 1111, Amsterdam Avenue, 1034 New York, NY 10025, USA
^b Division of Endocrinology, Diabetes and Nutrition, St Luke's-Roosevelt Hospital Center, New York, NY 10025, USA
^c Division of Gastroenterology and Liver Disease, St Luke's-Roosevelt Hospital Center, New York, NY 10025, USA
^d Department of Medicine, St Luke's-Roosevelt Hospital Center, New York, NY 10025, USA
^e Department of Surgery, St Luke's-Roosevelt Hospital Center, New York, NY 10025, USA
^f Columbia University College of Physicians and Surgeons, New York, NY 10025, USA

^⁎Corresponding author. New York Obesity Nutrition Research Center, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, 1111, Amsterdam Avenue, 1034 New York, NY 10025, USA. Tel.: +1 212 523 4643; fax: +1 212 523 4830.

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Abstract

Severe obesity is a preeminent health care problem that impacts overall health and survival. The most effective treatment for severe obesity is bariatric surgery, an intervention that not only maintains long-term weight loss but also is associated with improvement or remission of several comorbidies including type 2 diabetes mellitus. Some weight loss surgeries modify the gastrointestinal anatomy and physiology, including the secretions and actions of gut peptides. This review describes how bariatric surgery alters the patterns of gastrointestinal motility, nutrient digestion and absorption, gut peptide release, bile acids and the gut microflora, and how these changes alter energy homeostasis and glucose metabolism.

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Keywords : Obesity, Bariatric surgery, Gastric bypass, Diabetes, Gut peptides