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Type: Journal article
Title: Effects of posture and meal volume on gastric emptying, intestinal transit, oral glucose tolerance, blood pressure and gastrointestinal symptoms after Roux-en-Y gastric bypass
Author: Nguyen, N.
Debreceni, T.
Burgstad, C.
Wishart, J.
Bellon, M.
Rayner, C.
Wittert, G.
Horowitz, M.
Citation: Obesity Surgery, 2015; 25(8):1392-1400
Publisher: Springer US
Issue Date: 2015
ISSN: 0960-8923
Statement of
Nam Q. Nguyen, Tamara L. Debreceni, Carly M. Burgstad, Judith M. Wishart, Max Bellon, Chris K. Rayner, Gary A. Wittert, Michael Horowitz
Abstract: BACKGROUND: The purpose of this study is to determine the effects of posture and drink volume on gastric/pouch emptying (G/PE), intestinal transit, hormones, absorption, glycaemia, blood pressure and gastrointestinal (GI) symptoms after gastric bypass (Roux-en-Y gastric bypass (RYGB)). METHODS: Ten RYGB subjects were studied on four occasions in randomized order (sitting vs. supine posture; 50 vs. 150 ml of labelled water mixed with 3 g 3-O-methyl-D-glucose (3-OMG) and 50 g glucose). G/PE, caecal arrival time (CAT), blood glucose, plasma insulin, glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), peptide YY (PYY), 3-OMG, blood pressure, heart rate and GI symptoms were assessed over 240 min. Controls were ten volunteers with no medical condition or previous abdominal surgery, who were studied with the 150-ml drink in the sitting position. RESULTS: Compared to controls, PE (P < 0.001) and CAT (P < 0.001) were substantially more rapid in RYGB subjects. In RYGB, PE was more rapid in the sitting position (2.5 ± 0.7 vs. 16.6 ± 5.3 min, P = 0.02) and tends to be faster after 150 ml than the 50-ml drinks (9.5 ± 2.9 vs. 14.0 ± 3.5 min, P = 0.16). The sitting position and larger volume drinks were associated with greater releases of insulin, GLP-1 and PYY, as well as more hypotension (P < 0.01), tachycardia (P < 0.01) and postprandial symptoms (P < 0.001). CONCLUSIONS: Pouch emptying, blood pressure and GI symptoms after RYGB are dependent on both posture and meal volume.
Keywords: Posture; Pouch; Gastric emptying; Glucose absorption; Gastrointestinal hormones; Roux-en-Y gastric bypass
Rights: © Springer Science+Business Media New York 2014
DOI: 10.1007/s11695-014-1531-4
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