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Upper Gastrointestinal Function in Morbidly Obese Adolescents Before and 6 Months After Gastric Banding

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Abstract

Background

The effects of laparoscopic adjustable gastric band (LAGB) placement on upper gastrointestinal tract function in obese adolescents are unknown. Therefore, our aim was to determine the short-term effects of LAGB on esophageal motility, gastroesophageal reflux, gastric emptying, appetite-regulatory hormones, and perceptions of post-prandial hunger and fullness.

Methods

This study was part of a prospective cohort study (March 2009–December 2015) in one tertiary referral hospital. The study included obese adolescents (14–18 years) with a body mass index (BMI) > 40 (or ≥ 35 with comorbidities). Gastric emptying was assessed by 13C-octanoic acid breath test, pharyngeal, and esophageal motor function by high-resolution manometry with impedance (HRIM), and appetite and other perceptions using 100-mm visual analogue scales. Dysphagia symptoms were scored using a Dakkak questionnaire. Data were compared pre- and post-LAGB placement and at a 6-month follow-up.

Results

Based upon analysis of 15 adolescents, at the 6-month follow-up, LAGB placement: (i) led to a significant reduction in weight and BMI; (ii) increased fullness and decreased hunger post-meal; (iii) increased symptoms of dysphagia after solid food; and, despite these effects, (iv) caused little or no changes to appetite hormones, while (v) effects on gastric emptying, esophageal motility, esophageal bolus transport, and esophageal emptying were not significant.

Conclusion

In adolescents, LAGB improved BMI and altered the sensitivity to nutrients without significant effects on upper gastrointestinal tract physiology at the 6-month follow-up.

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Funding

Author 1 received a travel grant from the KNAW Termeulen Fund. There was no other external funding for this manuscript.

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Authors and Affiliations

  1. Department of Pediatric Gastroenterology and Nutrition, Emma Children’s Hospital/AMC, Amsterdam, The Netherlands

    M. Singendonk

  2. Gastroenterology Unit, Women’s & Children’s Hospital, Adelaide, Australia

    S. Kritas, L. Ferris & L. McCall

  3. Human Physiology, Medical Science and Technology, School of Medicine, Flinders University, Adelaide, South Australia, Australia

    T. Omari & L. Ferris

  4. Centre for Nutrition and Gastrointestinal Diseases, Adelaide Medical School, University of Adelaide, Adelaide, Australia

    C. Feinle-Bisset, C. L. Frisby & S. J. Kentish

  5. NHMRC Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide, Adelaide, Australia

    C. Feinle-Bisset

  6. South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia

    A. J. Page, C. L. Frisby & S. J. Kentish

  7. Paediatric Surgery & Urology, Women’s & Children’s Hospital, Adelaide, Australia

    S. Khurana

  8. Department of Surgery, Flinders Medical Centre, Adelaide, Australia

    L. Kow, J. Chisholm & S. Khurana

Authors
  1. M. Singendonk
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  2. S. Kritas
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  3. T. Omari
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  4. C. Feinle-Bisset
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  5. A. J. Page
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  6. C. L. Frisby
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  7. S. J. Kentish
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  8. L. Ferris
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  9. L. McCall
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  10. L. Kow
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  11. J. Chisholm
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  12. S. Khurana
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Corresponding author

Correspondence to T. Omari.

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Conflicts of Interest

Author 3 holds inventorship of Australian Patent 2011301768 that covers some of the analytical methods described. The other authors have no conflicts of interest relevant to this article to disclose.

Informed Consent

Informed consent was obtained from all individual participants included in this study.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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M Singendonk and S Kritas joint first authorship

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Singendonk, M., Kritas, S., Omari, T. et al. Upper Gastrointestinal Function in Morbidly Obese Adolescents Before and 6 Months After Gastric Banding. OBES SURG 28, 1277–1288 (2018). https://doi.org/10.1007/s11695-017-3000-3

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