A new questionnaire for quick assessment of food tolerance after bariatric surgery

Bariatric surgery is often associated with reduced food tolerance and sometimes frequent vomiting, which influence quality of life, but are not included in the overall evaluation of these procedures, notably the BAROS. Our aim was to develop a simple questionnaire to evaluate food tolerance during follow-up visits.

A one-page questionnaire including questions about overall satisfaction regarding quality of alimentation, timing of eating over the day, tolerance to several types of food, and frequency of vomiting/regurgitation was developed. A composite score was derived from this questionnaire, giving a score of 1 to 27. Validation was performed with a group of non-obese adults and a group of morbidly obese non-operated patients. Patients were administered the questionnaire at follow-up visits since January 1999. Data were collected prospectively.

It takes 1-2 minutes to fill out the questionnaire. Food tolerance is worse in the morbidly obese population compared with non-obese adults (24.2 vs 25.2, P=0.004). Following Roux-en-Y gastric bypass, food tolerance is reduced after 3 months (21.2), but becomes comparable to that of the normal population and remains so at 1 year postoperatively. Following gastric banding, food tolerance is already significantly reduced after 3 months (22.3), and worsens continuously over time (19.03 after 7 years). In the gastric banding population, the decision to adjust the band is based at least partially on food tolerance, and the questionnaire proved helpful in that respect.

Our new questionnaire proved very easy to use, and helpful in day-to-day practice, especially after gastric banding. It was also helpful in comparing food tolerance over time after surgery, and in comparing food tolerance between procedures. Evaluation of food tolerance should be part of the overall evaluation of the results after bariatric surgery.