Obesity Surgery

, Volume 27, Issue 5, pp 1292–1297 | Cite as

Gastrointestinal Quality of Life Improves Significantly After Sleeve Gastrectomy and Roux-en-Y Gastric Bypass—a Prospective Cross-Sectional Study Within a 2-Year Follow-up

  • Felix Nickel
  • Lukas Schmidt
  • Thomas Bruckner
  • Adrian T Billeter
  • Hannes G Kenngott
  • Beat-Peter Müller-Stich
  • Lars FischerEmail author
Original Contributions



Morbidly obese patients have lower quality of life (QOL) when compared to the general population. So far, no studies have compared gender and procedural differences in gastrointestinal QOL after sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB).


Patients before and after bariatric surgery completed the gastrointestinal quality of life index (GIQLI), a 36-item questionnaire with five subscores. Differences between SG and RYGB were analyzed, as were gender differences.


Some 186 patients completed the questionnaire, 75 before surgery, 56 within 6 months, and 55 within 24 months after surgery. Total GIQLI score and all subscores were significantly better within 24 months after surgery (80.9 ± 19.2 vs. 109.2 ± 17.7, p < 0.001). The specific gastrointestinal items ‘feeling of fullness’, ‘eating pleasure’, ‘slow speed of eating’, and ‘diarrhea’ were also significantly better after surgery whereas many other gastrointestinal items were not different. Total GIQLI score was significantly higher for SG than for RYGB within 6 months, while there were no significant differences within 24 months after surgery. There were also no significant differences in specific gastrointestinal items between SG and RYGB within 24 months after surgery and in total GIQLI score between female and male patients.


Total GIQLI score and all subscores were higher within 24 months after bariatric surgery. Total GIQLI score was significantly higher after SG when compared to RYGB within 6 months, but not different within 24 months after surgery. There was no difference in total GIQLI score between female and male patients.


Gastrointestinal symptoms Quality of life Gastric sleeve Roux-Y gastric bypass Bariatric surgery Obesity 



Body mass index


Diabetes mellitus type II


Excess weight loss


Gastroesophageal reflux disease


Gastrointestinal quality of life index


Quality of life


Randomized controlled trial


Roux-Y gastric bypass


Sleeve gastrectomy



We would like to thank Mr. Jonathan D. Hendrie for proofreading of the manuscript, and we would like to thank Ms. Marion Link for helping with the organization of the study.

Author Contributions

Study conception and design: LF, FN, HGK, BPM; acquisition of data: FN, LS, ATB, HGK, LF; analysis and interpretation of data: LF, FN, ATB, LS, TB; drafting of manuscript: FN, LS; critical revision: LF, TB, HGK, BPM.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no competing interests.

Ethical Statement

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.

Informed Consent Statement

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


  1. 1.
    Gellner R, Domschke W. Epidemiology of obesity. Chirurg. 2008;79(9):807–10. 812-6, 818CrossRefPubMedGoogle Scholar
  2. 2.
    Ogden CL et al. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA. 2014;311(8):806–14.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Fruhbeck G et al. Obesity: the gateway to ill health—an EASO position statement on a rising public health, clinical and scientific challenge in Europe. Obes Facts. 2013;6(2):117–20.CrossRefPubMedGoogle Scholar
  4. 4.
    Guh DP et al. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health. 2009;9:88.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Kuk JL et al. Edmonton Obesity Staging System: association with weight history and mortality risk. Appl Physiol Nutr Metab. 2011;36(4):570–6.CrossRefPubMedGoogle Scholar
  6. 6.
    Andersen JR et al. Health-related quality of life after bariatric surgery: a systematic review of prospective long-term studies. Surg Obes Relat Dis. 2015;11(2):466–73.CrossRefPubMedGoogle Scholar
  7. 7.
    Jia H, Lubetkin EI. The impact of obesity on health-related quality-of-life in the general adult US population. J Public Health (Oxf). 2005;27(2):156–64.CrossRefGoogle Scholar
  8. 8.
    Kolotkin RL, Meter K, Williams GR. Quality of life and obesity. Obes Rev. 2001;2(4):219–29.CrossRefPubMedGoogle Scholar
  9. 9.
    Clements RH 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.CrossRefPubMedGoogle Scholar
  10. 10.
    Yu P-J. Impairment of gastrointestinal quality of life in severely obese patients. World J Gastroenterol. 2014;20(22):7027.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Poves I et al. Gastrointestinal quality of life after laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2006;16(1):19–23.CrossRefPubMedGoogle Scholar
  12. 12.
    Mingrone G et al. Bariatric–metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow-up of an open-label, single-centre, randomised controlled trial. Lancet. 2015;386(9997):964–73.CrossRefPubMedGoogle Scholar
  13. 13.
    Sjostrom L. Review of the key results from the Swedish Obese Subjects (SOS) trial—a prospective controlled intervention study of bariatric surgery. J Intern Med. 2013;273(3):219–34.CrossRefPubMedGoogle Scholar
  14. 14.
    Sjostrom L. Bariatric surgery and reduction in morbidity and mortality: experiences from the SOS study. Int J Obes. 2008;32(Suppl 7):S93–7.CrossRefGoogle Scholar
  15. 15.
    Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2011. Obes Surg. 2013;23(4):427–36.CrossRefPubMedGoogle Scholar
  16. 16.
    Sarwer DB, Steffen KJ. Quality of life, body image and sexual functioning in bariatric surgery patients. Eur Eat Disord Rev. 2015;23(6):504–8.CrossRefPubMedGoogle Scholar
  17. 17.
    Overs SE et al. Food tolerance and gastrointestinal quality of life following three bariatric procedures: adjustable gastric banding, Roux-en-Y gastric bypass, and sleeve gastrectomy. Obes Surg. 2011;22(4):536–43.CrossRefGoogle Scholar
  18. 18.
    Hachem A, Brennan L. Quality of life outcomes of bariatric surgery: a systematic review. Obes Surg. 2015; doi: 10.1007/s11695-015-1940-z.Google Scholar
  19. 19.
    Eypasch E et al. Gastrointestinal quality of life index: development, validation and application of a new instrument. Br J Surg. 1995;82(2):216–22.CrossRefPubMedGoogle Scholar
  20. 20.
    Lee YC et al. Gastrointestinal quality of life following bariatric surgery in Asian patients. Hepato-Gastroenterology. 2013;60(124):759–61.PubMedGoogle Scholar
  21. 21.
    Lee WJ et al. Gastro-intestinal quality of life after metabolic surgery for the treatment of type 2 diabetes mellitus. Obes Surg. 2015;25(8):1371–9.CrossRefPubMedGoogle Scholar
  22. 22.
    Ser KH et al. Experience in laparoscopic sleeve gastrectomy for morbidly obese Taiwanese: staple-line reinforcement is important for preventing leakage. Surg Endosc. 2010;24(9):2253–9.CrossRefPubMedGoogle Scholar
  23. 23.
    Forgione A et al. Prospective evaluation of functional outcome after laparoscopic sigmoid colectomy. Ann Surg. 2009;249(2):218–24.CrossRefPubMedGoogle Scholar
  24. 24.
    Mathus-Vliegen EM. Long-term weight loss after bariatric surgery in patients visited at home outside the study environment. Obes Surg. 2006;16(11):1508–19.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Felix Nickel
    • 1
  • Lukas Schmidt
    • 1
  • Thomas Bruckner
    • 2
  • Adrian T Billeter
    • 1
  • Hannes G Kenngott
    • 1
  • Beat-Peter Müller-Stich
    • 1
  • Lars Fischer
    • 1
    Email author
  1. 1.Department of General, Visceral, and Transplant SurgeryUniversity of HeidelbergHeidelbergGermany
  2. 2.Institute for Medical Biometry and InformaticsUniversity of HeidelbergHeidelbergGermany

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