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The pros and cons of gastric bypass surgery – The role of the Roux-limb

Journal article
Authors Per Björklund
Lars Fändriks
Published in Best Practice and Research: Clinical Gastroenterology
Volume 40-41
ISSN 1521-6918
Publication year 2019
Published at Institute of Clinical Sciences, Department of Gastrosurgical Research and Education
Language en
Keywords Abdominal pain, Bariatric, Intestinal motility, Manometry, Opioid analgesics, opiate, bariatric surgery, chronic pain, epidemic, gastric bypass surgery, human, intestine motility, intestine pressure, metabolic disorder, mucosa inflammation, nausea, obesity, obesity management, postoperative complication, postoperative pain, Review, risk factor, Roux limb gastric bypass, Roux-en-Y gastric bypass, stomach pouch, surgical technique
Subject categories Surgery, Gastroenterology and Hepatology


The prevalence of overweight and obesity has exploded in the post-industrial era. Life style interventions like dieting and exercise can induce a marked weight loss, but the main problem for most patients is to maintain the reduced body weight over time. Gastric bypass surgery is a commonly performed and very effective method for achieving a pronounced and sustained weight loss including metabolic improvements in obese patients. Despite the therapeutic successfulness there are known side-effects like chronic postprandial nausea and pain that in some patients become intractable. The pathophysiology is complex and partly unexplored. The physician or surgeon handling a patient with “post-bariatric symptoms” must be aware of the risk for symptom aggravations due to iatrogenic opioid-associated intestinal dysmotility. The present paper gives a brief overview of obesity surgery and its associated postsurgical conditions with a focus on the unexplored role of the Roux-limb following gastric bypass surgery. © 2019 Elsevier Ltd

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