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Gastrointestinal disturbances with obesity
R J Lieverse1, J B Jansen, A A Masclee
1Dept. of Gastroenterology and Hepatology, University Hospital Leiden, The Netherlands.
Scandinavian Journal of Gastroenterology. Supplement
|January 1, 1993
Summary
Obesity is linked to fatty liver disease and an increased risk of gallstones, especially during rapid weight loss. Surgical obesity treatments require monitoring for nutritional deficiencies and complications like dumping syndrome.
Area of Science:
- Gastroenterology
- Hepatology
- Bariatric Surgery
Background:
- Obesity is associated with non-alcoholic steatohepatitis (NASH), which often has a benign course despite histological changes.
- Elevated insulin levels may play a role in NASH pathogenesis, and weight reduction can lead to regression of fatty liver changes.
- Obese individuals have an increased risk of gallstones due to cholesterol-saturated bile and potential gallbladder stasis, with incidence rising during rapid weight loss diets.
Purpose of the Study:
- To review the gastrointestinal and hepatic manifestations of obesity.
- To discuss the impact of weight reduction on fatty liver disease and gallstone formation.
- To explore surgical options for obesity and their associated complications.
Main Methods:
- Literature review of studies on obesity, steatosis, steatohepatitis, gallstones, and gastrointestinal issues.
- Analysis of the role of insulin in obesity-related liver disease.
- Evaluation of bariatric surgery outcomes and complications.
Main Results:
- Weight reduction significantly improves fatty liver changes in obese patients.
- Very low-calorie diets increase gallstone incidence, with ursodeoxycholic acid showing prophylactic potential.
- Obesity is linked to increased colorectal cancer risk in males; bariatric surgery has complications like nutritional deficiencies and dumping syndrome.
Conclusions:
- Obesity presents multifaceted gastrointestinal and hepatic challenges, including fatty liver disease and gallstone formation.
- Weight management strategies, including bariatric surgery, require careful monitoring for potential complications and nutritional deficiencies.
- Further research is needed to clarify the role of gastrointestinal peptides in obesity-related disorders.