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OBES SURG (2010) 20:14081414 DOI 10.1007/s11695-010-0192-1
PHYSIOLOGY RESEARCH
Is the Roux Limb a Determinant for Meal Size After Gastric Bypass Surgery?
Per Bjrklund & Anna Laurenius & Eva Een &
Torsten Olbers & Hans Lnroth & Lars Fndriks
Published online: 2 June 2010# The Author(s) 2010. This article is published with open access at Springerlink.com
Abstract The Roux-Y gastric bypass (RYGBP) is an effective weight-reducing procedure but the involved mechanisms of action are obscure. The Roux limb is the intestinal segment that following surgery is the primary recipient for food intake. The aims of the study were to explore the mechanosensory and biomechanical properties of the Roux limb and to make correlations with preferred meal size. Ten patients participated and were examined preoperatively, 6 weeks and 1 year after RYGBP. Each subject ingested unrestricted amounts of a standardized meal and the weight of the meal was recorded. On another study day, the Roux limb was subjected to gradual distension by the use of an intraluminal balloon. Luminal volumepressure relationships and thresholds for induction of sensations were monitored. At 6 weeks and 1 year post surgery, the subjects had reduced their meal sizes by 62% and 41% (medians), respectively, compared to preoperative values. The thresholds for eliciting distension-induced sensations were strongly and negatively correlated to the preferred meal size. Intraluminal pressure during Roux limb distension, both at low and high balloon volumes, correlated negatively to the size of the meal that the patients had chosen to eat. The results suggest that the Roux limb is an
important determinant for regulating food intake after Roux-Y bypass bariatric surgery.
Keywords Jejunum . Biomechanics . Appetite . Intestinal . Motor activity. Food intake
Introduction
The exceptional effectiveness of bariatric surgery to treat morbid obesity has highlighted the central role of the gastrointestinal tract in the regulation of body weight and metabolism [1, 2]. However, the mechanisms of action behind the altered food intake and improved metabolic control following surgery are still not completely cleared out. Weight-reducing surgical interventions were originally based on the simple principle of preventing nutrients to be digested or to be absorbed by the intestines. This could be achieved either by restricting food intake or by inducing a condition of intestinal malabsorption. The former principle...