Upper Gastrointestinal Function in Morbidly Obese Adolescents before and Six Months after Gastric Banding.

M Singendonk, S Kritas, T Omari, C Feinle-Bisset, A Page, C Frisby, S Kentish, L McCall, L Kow, J Chisholm, Sanjeev Khurana

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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.

Original languageEnglish
Pages (from-to)1277-1288
Number of pages12
JournalObesity Surgery
Volume28
Issue number5
DOIs
Publication statusPublished - 2018

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    Singendonk, M., Kritas, S., Omari, T., Feinle-Bisset, C., Page, A., Frisby, C., Kentish, S., McCall, L., Kow, L., Chisholm, J., & Khurana, S. (2018). Upper Gastrointestinal Function in Morbidly Obese Adolescents before and Six Months after Gastric Banding. Obesity Surgery, 28(5), 1277-1288. https://doi.org/10.1007/s11695-017-3000-3