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Published in: Obesity Surgery 11/2015

01-11-2015 | Original Contributions

Functional Gastrointestinal Disorders in Obese Patients. The Importance of the Enrollment Source

Authors: Michel Bouchoucha, Marinos Fysekidis, Chantal Julia, Gheorghe Airinei, Jean-Marc Catheline, Gérard Reach, Robert Benamouzig

Published in: Obesity Surgery | Issue 11/2015

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Abstract

Background

Obesity is frequently associated to many functional gastrointestinal disorders. The aim of the present study was to assess the prevalence of functional gastrointestinal disorders in obese patients, according to their body mass index and their recruitment source.

Methods

Five hundred ninety-six obese patients (body mass index (BMI) > 30) filled out a standard questionnaire in order to evaluate the presence of functional gastrointestinal disorders. They were divided into four groups according to the Rome III criteria and their BMI: OF, obese patients from functional gastrointestinal disorder (FGID) enrollment; OO, obese patients from obesity management enrollment; MF, morbid obesity patients from FGID enrollment; and MO, morbid obesity patients from obesity management enrollment. Data analysis was performed using multivariate logistic regression.

Results

Out of the 596 obese patients included in the present study, 183 (33 %) were complaining of FGIDs, while 413 (67 %) were consulting for obesity management. Compared to the OF group, the OO patients had a higher prevalence of females (P = 0.008) and a younger age (P < 0.001). Clinically, they reported a lower incidence of regurgitation (P = 0.044), of chest pain (P = 0.004), of irritable bowel syndrome (IBS; P = 0.035), and of functional diarrhea (P = 0.030). Compared to the MF group, the MO patients had an older age (P = 0.001), a higher BMI (P = 0.013), and clinically by a high frequency of functional dyspepsia (P = 0.006). There were symptoms that had similar prevalence in all groups (OF, OO, MF, MO) such as epigastric pain, postprandial distress, constipation, diarrhea, bloating, abdominal pain soiling, or nonspecific anorectal disorders.

Conclusions

This study has shown that the recruitment source accounted for marked and specific differences in the prevalence of functional gastrointestinal disorders in obesity and morbid obesity. Symptoms with similar prevalence in all groups should be systematically detected in all patients.
Literature
3.
go back to reference INSERM, editor. ObEpi-Roche 2012: enquête nationale sur l’obésité et le surpoids. 6 ed: INSERM/KANTAR HEALTH/ROCHE; 2013. INSERM, editor. ObEpi-Roche 2012: enquête nationale sur l’obésité et le surpoids. 6 ed: INSERM/KANTAR HEALTH/ROCHE; 2013.
4.
go back to reference Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA. 2012;307(5):491–7.CrossRefPubMed Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA. 2012;307(5):491–7.CrossRefPubMed
5.
go back to reference Finkelstein EA, Trogdon JG, Cohen JW, Dietz W. Annual medical spending attributable to obesity: payer- and service-specific estimates. Health Aff (Millwood). 2009;28(5):w822–31.CrossRef Finkelstein EA, Trogdon JG, Cohen JW, Dietz W. Annual medical spending attributable to obesity: payer- and service-specific estimates. Health Aff (Millwood). 2009;28(5):w822–31.CrossRef
6.
go back to reference Galmiche JP, Clouse RE, Balint A, Cook IJ, Kahrilas PJ, Paterson WG, et al. Functional esophageal disorders. Gastroenterology. 2006;130(5):1459–65.CrossRefPubMed Galmiche JP, Clouse RE, Balint A, Cook IJ, Kahrilas PJ, Paterson WG, et al. Functional esophageal disorders. Gastroenterology. 2006;130(5):1459–65.CrossRefPubMed
7.
go back to reference Tack J, Talley NJ, Camilleri M, Holtmann G, Hu P, Malagelada JR, et al. Functional gastroduodenal disorders. Gastroenterology. 2006;130(5):1466–79.CrossRefPubMed Tack J, Talley NJ, Camilleri M, Holtmann G, Hu P, Malagelada JR, et al. Functional gastroduodenal disorders. Gastroenterology. 2006;130(5):1466–79.CrossRefPubMed
8.
go back to reference Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology. 2006;130(5):1480–91.CrossRefPubMed Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology. 2006;130(5):1480–91.CrossRefPubMed
9.
go back to reference Clouse RE, Mayer EA, Aziz Q, Drossman DA, Dumitrascu DL, Monnikes H, et al. Functional abdominal pain syndrome. Gastroenterology. 2006;130(5):1492–7.CrossRefPubMed Clouse RE, Mayer EA, Aziz Q, Drossman DA, Dumitrascu DL, Monnikes H, et al. Functional abdominal pain syndrome. Gastroenterology. 2006;130(5):1492–7.CrossRefPubMed
10.
go back to reference Bharucha AE, Wald A, Enck P, Rao S. Functional anorectal disorders. Gastroenterology. 2006;130(5):1510–8.CrossRefPubMed Bharucha AE, Wald A, Enck P, Rao S. Functional anorectal disorders. Gastroenterology. 2006;130(5):1510–8.CrossRefPubMed
11.
go back to reference Drossman DA. The functional gastrointestinal disorders and the Rome III process. Gastroenterology. 2006;130(5):1377–90.CrossRefPubMed Drossman DA. The functional gastrointestinal disorders and the Rome III process. Gastroenterology. 2006;130(5):1377–90.CrossRefPubMed
12.
go back to reference Talley NJ, Zinsmeister AR, Melton 3rd LJ. Irritable bowel syndrome in a community: symptom subgroups, risk factors, and health care utilization. Am J Epidemiol. 1995;142(1):76–83.PubMed Talley NJ, Zinsmeister AR, Melton 3rd LJ. Irritable bowel syndrome in a community: symptom subgroups, risk factors, and health care utilization. Am J Epidemiol. 1995;142(1):76–83.PubMed
13.
go back to reference Clements RH, Gonzalez QH, Foster A, Richards WO, McDowell J, Bondora A, et al. Gastrointestinal symptoms are more intense in morbidly obese patients and are improved with laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2003;13(4):610–4.CrossRefPubMed Clements RH, Gonzalez QH, Foster A, Richards WO, McDowell J, Bondora A, et al. Gastrointestinal symptoms are more intense in morbidly obese patients and are improved with laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2003;13(4):610–4.CrossRefPubMed
14.
go back to reference Talley NJ, Howell S, Poulton R. Obesity and chronic gastrointestinal tract symptoms in young adults: a birth cohort study. Am J Gastroenterol. 2004;99(9):1807–14.CrossRefPubMed Talley NJ, Howell S, Poulton R. Obesity and chronic gastrointestinal tract symptoms in young adults: a birth cohort study. Am J Gastroenterol. 2004;99(9):1807–14.CrossRefPubMed
15.
go back to reference Delgado-Aros S, Locke 3rd GR, Camilleri M, Talley NJ, Fett S, Zinsmeister AR, et al. Obesity is associated with increased risk of gastrointestinal symptoms: a population-based study. Am J Gastroenterol. 2004;99(9):1801–6.CrossRefPubMed Delgado-Aros S, Locke 3rd GR, Camilleri M, Talley NJ, Fett S, Zinsmeister AR, et al. Obesity is associated with increased risk of gastrointestinal symptoms: a population-based study. Am J Gastroenterol. 2004;99(9):1801–6.CrossRefPubMed
16.
go back to reference Mathus-Vliegen EM, Tygat GN. Gastro-oesophageal reflux in obese subjects: influence of overweight, weight loss and chronic gastric balloon distension. Scand J Gastroenterol. 2002;37(11):1246–52.CrossRefPubMed Mathus-Vliegen EM, Tygat GN. Gastro-oesophageal reflux in obese subjects: influence of overweight, weight loss and chronic gastric balloon distension. Scand J Gastroenterol. 2002;37(11):1246–52.CrossRefPubMed
17.
go back to reference Levy RL, Linde JA, Feld KA, Crowell MD, Jeffery RW. The association of gastrointestinal symptoms with weight, diet, and exercise in weight-loss program participants. Clin Gastroenterol Hepatol. 2005;3(10):992–6.CrossRefPubMed Levy RL, Linde JA, Feld KA, Crowell MD, Jeffery RW. The association of gastrointestinal symptoms with weight, diet, and exercise in weight-loss program participants. Clin Gastroenterol Hepatol. 2005;3(10):992–6.CrossRefPubMed
18.
go back to reference Talley NJ, Quan C, Jones MP, Horowitz M. Association of upper and lower gastrointestinal tract symptoms with body mass index in an Australian cohort. Neurogastroenterol Motil. 2004;16(4):413–9.CrossRefPubMed Talley NJ, Quan C, Jones MP, Horowitz M. Association of upper and lower gastrointestinal tract symptoms with body mass index in an Australian cohort. Neurogastroenterol Motil. 2004;16(4):413–9.CrossRefPubMed
19.
go back to reference Vakil N. Body mass index and gastroesophageal reflux disease: implications of the obesity epidemic. Dig Dis Sci. 2008;53(9):2291–2.CrossRefPubMed Vakil N. Body mass index and gastroesophageal reflux disease: implications of the obesity epidemic. Dig Dis Sci. 2008;53(9):2291–2.CrossRefPubMed
20.
go back to reference Fysekidis M, Bouchoucha M, Bihan H, Reach G, Benamouzig R, Catheline JM. Prevalence and co-occurrence of upper and lower functional gastrointestinal symptoms in patients eligible for bariatric surgery. Obes Surg. 2012;22(3):403–10.CrossRefPubMed Fysekidis M, Bouchoucha M, Bihan H, Reach G, Benamouzig R, Catheline JM. Prevalence and co-occurrence of upper and lower functional gastrointestinal symptoms in patients eligible for bariatric surgery. Obes Surg. 2012;22(3):403–10.CrossRefPubMed
21.
go back to reference Bouchoucha M, Fysekidis M, Catheline J-M, Airinei G, Reach G, Aparicio T, et al., editors. Modification de la symptomatologie fonctionnelle digestive des patients souffrant d’obésité morbide après chirurgie bariatrique Journées Francophones d’Hépato-gastroentérologie et d’oncologie Digestive; 2014; Paris. Bouchoucha M, Fysekidis M, Catheline J-M, Airinei G, Reach G, Aparicio T, et al., editors. Modification de la symptomatologie fonctionnelle digestive des patients souffrant d’obésité morbide après chirurgie bariatrique Journées Francophones d’Hépato-gastroentérologie et d’oncologie Digestive; 2014; Paris.
22.
go back to reference Bouchoucha M, Devroede G, Arsac M. Anismus: a marker of multi-site functional disorders? Int J Colorectal Dis. 2004;19(4):374–9.CrossRefPubMed Bouchoucha M, Devroede G, Arsac M. Anismus: a marker of multi-site functional disorders? Int J Colorectal Dis. 2004;19(4):374–9.CrossRefPubMed
23.
go back to reference Locke 3rd GR, Talley NJ, Fett SL, Zinsmeister AR, Melton 3rd LJ. Risk factors associated with symptoms of gastroesophageal reflux. Am J Med. 1999;106(6):642–9.CrossRefPubMed Locke 3rd GR, Talley NJ, Fett SL, Zinsmeister AR, Melton 3rd LJ. Risk factors associated with symptoms of gastroesophageal reflux. Am J Med. 1999;106(6):642–9.CrossRefPubMed
24.
go back to reference Nilsson M, Johnsen R, Ye W, Hveem K, Lagergren J. Obesity and estrogen as risk factors for gastroesophageal reflux symptoms. JAMA. 2003;290(1):66–72.CrossRefPubMed Nilsson M, Johnsen R, Ye W, Hveem K, Lagergren J. Obesity and estrogen as risk factors for gastroesophageal reflux symptoms. JAMA. 2003;290(1):66–72.CrossRefPubMed
25.
go back to reference Dutta SK, Arora M, Kireet A, Bashandy H, Gandsas A. Upper gastrointestinal symptoms and associated disorders in morbidly obese patients: a prospective study. Dig Dis Sci. 2009;54(6):1243–6.CrossRefPubMed Dutta SK, Arora M, Kireet A, Bashandy H, Gandsas A. Upper gastrointestinal symptoms and associated disorders in morbidly obese patients: a prospective study. Dig Dis Sci. 2009;54(6):1243–6.CrossRefPubMed
26.
go back to reference Andersen LI, Jensen G. Risk factors for benign oesophageal disease in a random population sample. J Intern Med. 1991;230(1):5–10.CrossRefPubMed Andersen LI, Jensen G. Risk factors for benign oesophageal disease in a random population sample. J Intern Med. 1991;230(1):5–10.CrossRefPubMed
27.
go back to reference Zalar A, Haddouche B, Antonietti M, Alhameedi R, Iwanicki-Caron I, Lecleire S, et al. Lack of correlation between morbid obesity and severe gastroesophageal reflux disease in candidates for bariatric surgery: results of a large prospective study. Obes Surg. 2013;23(11):1939–41.CrossRefPubMed Zalar A, Haddouche B, Antonietti M, Alhameedi R, Iwanicki-Caron I, Lecleire S, et al. Lack of correlation between morbid obesity and severe gastroesophageal reflux disease in candidates for bariatric surgery: results of a large prospective study. Obes Surg. 2013;23(11):1939–41.CrossRefPubMed
28.
go back to reference Swartz DE, Mobley E, Felix EL. Bile reflux after Roux-en-Y gastric bypass: an unrecognized cause of postoperative pain. Surg Obes Relat Dis. 2009;5(1):27–30.CrossRefPubMed Swartz DE, Mobley E, Felix EL. Bile reflux after Roux-en-Y gastric bypass: an unrecognized cause of postoperative pain. Surg Obes Relat Dis. 2009;5(1):27–30.CrossRefPubMed
29.
go back to reference Cremonini F, Locke 3rd GR, Schleck CD, Zinsmeister AR, Talley NJ. Relationship between upper gastrointestinal symptoms and changes in body weight in a population-based cohort. Neurogastroenterol Motil. 2006;18(11):987–94.CrossRefPubMed Cremonini F, Locke 3rd GR, Schleck CD, Zinsmeister AR, Talley NJ. Relationship between upper gastrointestinal symptoms and changes in body weight in a population-based cohort. Neurogastroenterol Motil. 2006;18(11):987–94.CrossRefPubMed
30.
go back to reference Lopez-Alvarenga JC, Vargas JA, Lopez LH, Fass R, Sobrino-Cossio S, Higgins P, et al. Effect of body weight and esophageal damage on the severity of gastroesophageal reflux symptoms. Mexican GERD working group. Arch Med Res. 2009;40(7):576–81.PubMedCentralCrossRefPubMed Lopez-Alvarenga JC, Vargas JA, Lopez LH, Fass R, Sobrino-Cossio S, Higgins P, et al. Effect of body weight and esophageal damage on the severity of gastroesophageal reflux symptoms. Mexican GERD working group. Arch Med Res. 2009;40(7):576–81.PubMedCentralCrossRefPubMed
31.
go back to reference Le Pluart D, Sabaté JM, Bouchoucha M, Hercberg S, Benamouzig R, Julia C. Functional gastrointestinal disorders in 35,447 adults and their association with body mass index. Aliment Pharmacol Ther. 2015;In Press. Le Pluart D, Sabaté JM, Bouchoucha M, Hercberg S, Benamouzig R, Julia C. Functional gastrointestinal disorders in 35,447 adults and their association with body mass index. Aliment Pharmacol Ther. 2015;In Press.
32.
go back to reference Cremonini F, Camilleri M, Clark MM, Beebe TJ, Locke GR, Zinsmeister AR, et al. Associations among binge eating behavior patterns and gastrointestinal symptoms: a population-based study. Int J Obes (Lond). 2009;33(3):342–53.CrossRef Cremonini F, Camilleri M, Clark MM, Beebe TJ, Locke GR, Zinsmeister AR, et al. Associations among binge eating behavior patterns and gastrointestinal symptoms: a population-based study. Int J Obes (Lond). 2009;33(3):342–53.CrossRef
33.
go back to reference Santonicola A, Angrisani L, Ciacci C, Iovino P. Prevalence of functional gastrointestinal disorders according to Rome III criteria in Italian morbidly obese patients. ScientificWorldJournal. 2013;2013:532503.PubMedCentralCrossRefPubMed Santonicola A, Angrisani L, Ciacci C, Iovino P. Prevalence of functional gastrointestinal disorders according to Rome III criteria in Italian morbidly obese patients. ScientificWorldJournal. 2013;2013:532503.PubMedCentralCrossRefPubMed
34.
go back to reference Aslam M, Slaughter JC, Goutte M, Garrett CG, Hagaman D, Vaezi MF. Nonlinear relationship between body mass index and esophageal acid exposure in the extraesophageal manifestations of reflux. Clin Gastroenterol Hepatol. 2012;10(8):874–8.CrossRefPubMed Aslam M, Slaughter JC, Goutte M, Garrett CG, Hagaman D, Vaezi MF. Nonlinear relationship between body mass index and esophageal acid exposure in the extraesophageal manifestations of reflux. Clin Gastroenterol Hepatol. 2012;10(8):874–8.CrossRefPubMed
35.
go back to reference Hampel H, Abraham NS, El-Serag HB. Meta-analysis: obesity and the risk for gastroesophageal reflux disease and its complications. Ann Intern Med. 2005;143(3):199–211.CrossRefPubMed Hampel H, Abraham NS, El-Serag HB. Meta-analysis: obesity and the risk for gastroesophageal reflux disease and its complications. Ann Intern Med. 2005;143(3):199–211.CrossRefPubMed
36.
go back to reference Corley DA, Kubo A. Body mass index and gastroesophageal reflux disease: a systematic review and meta-analysis. Am J Gastroenterol. 2006;101(11):2619–28.CrossRefPubMed Corley DA, Kubo A. Body mass index and gastroesophageal reflux disease: a systematic review and meta-analysis. Am J Gastroenterol. 2006;101(11):2619–28.CrossRefPubMed
37.
go back to reference Jacobson BC, Schroy 3rd PC. The skinny on obesity and reflux. Gastroenterology. 2006;130(6):1925–6.CrossRefPubMed Jacobson BC, Schroy 3rd PC. The skinny on obesity and reflux. Gastroenterology. 2006;130(6):1925–6.CrossRefPubMed
39.
40.
Metadata
Title
Functional Gastrointestinal Disorders in Obese Patients. The Importance of the Enrollment Source
Authors
Michel Bouchoucha
Marinos Fysekidis
Chantal Julia
Gheorghe Airinei
Jean-Marc Catheline
Gérard Reach
Robert Benamouzig
Publication date
01-11-2015
Publisher
Springer US
Published in
Obesity Surgery / Issue 11/2015
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-015-1679-6

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