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Faculty of Medical Sciences

Fecale Diagnostiek na Roux-en-Y Gastric Bypass.

Westerink, F. (Floris) (2015) Fecale Diagnostiek na Roux-en-Y Gastric Bypass. thesis, Medicine.

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Abstract

Background: The prevalence of (morbid) obesity continues to rise worldwide. The Roux-en-Y gastric bypass surgery is an effective treatment method for morbid obesity. Because of the altered anatomy, gastrointestinal functionality and feces composition after RYGB, the validity of fecal diagnostic tests can be changed. To keep the tests in use for this post RYGB subpopulation, new reference values need to be determined. Method: This study investigated the mean and median values for fecal calprotectine (FCP), elastase-1 (FE1) and alpha-1-antitrypsin (A1AT), by collecting stool samples of 125 patients, 12-24 months after RYGB. Results: The mean FCP in μg/g is 180 (SD 108,3), the median is 162 (IQR 159). The 97,5th percentile (90% CI) is 422 (378-494) μg/g. FE1 has a mean in μg/g of 403 (SD 161), the median is 444 (IQR 184). The 2,5th percentile (90% CI) is 15 (15-55) μg/g. The mean concentration of fecal A1AT in mg/g dry feces is 0,57 (SD 0,30), the median is 0,55 (IQR 0,50). The 97,5th percentile (90% CI) is 1,15 (1,08-1,27) mg/g dry feces. There is a positive correlation between FCP and A1AT (0,52; p<0,01). Conclusions: The FCP after RYGB rises. In the future a higher reference value (422 μg/g) for the FCP test after RYGB has to be applied. The high median FCP gives rise to the hypothesis that persistent gastrointestinal inflammatory processes occur after RYGB. The median FE1 in patients after RYGB is decreased, but stays within the reference values for the population. Fecal A1AT after RYGB stays a reliable diagnostic tool with unchanged reference values. Further research is needed to determine the location and what kind of patho- or physiological inflammatory processes cause the elevated fecal calprotectine after RYGB.

Item Type: Thesis (Thesis)
Supervisor name: Gerdes, dr. V.E.A. and Boerlage, drs. T.C.C. and Slotervaartziekenhuis and dr. M.A.C. Meijssen and Isala Zwolle
Faculty: Medical Sciences
Date Deposited: 25 Jun 2020 10:47
Last Modified: 25 Jun 2020 10:47
URI: https://umcg.studenttheses.ub.rug.nl/id/eprint/848

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