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a-00021                    Dr. Robert RUTLEDGE   Title of Paper: GLUTEN SENSITIVITY AS A CAUSE OFSIGNIFICANT GASTROINTESTI...
GLUTEN SENSITIVITY AS A   CAUSE OF SIGNIFICANTGASTROINTESTINAL SYMPTOMS AFTER MINI-GASTRIC BYPASS            Robert RUTLED...
Introduction• Gluten sensitivity (GS), Celiac Disease, is  under-diagnosed in the population and its  frequency is increas...
Foods Usually Made with Wheat•   Pasta             • Cereal•   Couscous          • Crackers•   Bread             • Beer•  ...
Introduction• Post op Gastro-Intestinal (GI) symptoms,  similar to those seen in GS are common  after bariatric surgery an...
Introduction• Recently empirical trials of gluten free  diets ha successfully resolved GI  symptoms in several post Mini-G...
Methods:• Survey of 1,595 Mini-Gastric Bypass  (MGB) patients to• Assess results of the MGB,• Presence of GI symptoms,• Pr...
Results• Few patients had heard of GS or Celiac  Disease.• Only one person had been diagnosed  with GS pre or post op.• Re...
Conclusions:• In spite of excellent weight loss and high  levels of patient satisfaction, as many as  half of all MGB pati...
Conclusions• The restructuring of the GI tract may  increase the risk of GS after bypass.• Of the MGB patients reporting G...
Conclusions• This is the first report of high levels of  GS after gastric bypass.• GS is under diagnosed and it may often ...
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Apc a-00021-gluten sensitivity

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Apc a-00021-gluten sensitivity

  1. 1. a-00021 Dr. Robert RUTLEDGE Title of Paper: GLUTEN SENSITIVITY AS A CAUSE OFSIGNIFICANT GASTROINTESTINAL SYMPTOMS AFTER MINI- GASTRIC BYPASS Nationality: United States of America Position: Director Department: Surgery Organization: Center For Laparoscopic Obesity Surgery Tel: +1-702 714 0011 E-mail: drr@clos.net
  2. 2. GLUTEN SENSITIVITY AS A CAUSE OF SIGNIFICANTGASTROINTESTINAL SYMPTOMS AFTER MINI-GASTRIC BYPASS Robert RUTLEDGE11Director, Surgery, Center For Laparoscopic Obesity Surgery, United States of America
  3. 3. Introduction• Gluten sensitivity (GS), Celiac Disease, is under-diagnosed in the population and its frequency is increasing.• Symptoms of gluten sensitivity include bloating, abdominal discomfort or pain, constipation and diarrhea
  4. 4. Foods Usually Made with Wheat• Pasta • Cereal• Couscous • Crackers• Bread • Beer• Flour Tortillas • Oats (see the• Cookies section on oats• Cakes below)• Muffins • Gravy• Pastries • Dressings • Sauces
  5. 5. Introduction• Post op Gastro-Intestinal (GI) symptoms, similar to those seen in GS are common after bariatric surgery and can be a difficult diagnostic and therapeutic dilemma (GERD, Abdominal bloating/pain, Diarrhea/constipation, Nausea/Vomiting.)
  6. 6. Introduction• Recently empirical trials of gluten free diets ha successfully resolved GI symptoms in several post Mini-Gastric Bypass patients.• The purpose of this study was to survey MGB patients for GI symptoms and for results of trials of gluten free diets on these symptoms.
  7. 7. Methods:• Survey of 1,595 Mini-Gastric Bypass (MGB) patients to• Assess results of the MGB,• Presence of GI symptoms,• Pre and post op GI and the• Impact of a gluten free diet on GI symptoms.
  8. 8. Results• Few patients had heard of GS or Celiac Disease.• Only one person had been diagnosed with GS pre or post op.• Remarkably, 50.6% reported GS after surgery.• Of the patients reporting GS, 50% had “gotten better by excluding gluten foods from my diet after surgery.”
  9. 9. Conclusions:• In spite of excellent weight loss and high levels of patient satisfaction, as many as half of all MGB patients report GI symptoms similar to those of gluten sensitivity.• This high rate in bypass patients is much higher than in the general population.
  10. 10. Conclusions• The restructuring of the GI tract may increase the risk of GS after bypass.• Of the MGB patients reporting GS,• Half of these patients reported that excluding gluten from their diet• Caused marked symptomatic improvement.
  11. 11. Conclusions• This is the first report of high levels of GS after gastric bypass.• GS is under diagnosed and it may often be missed.• If the findings of this report are confirmed, this knowledge could guide successful diagnosis and treatment of these difficult patients.

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