Ulcer Bug May Affect Weight Loss Surgery

Screening, Treatment for <em>H. pylori</em> May Help Avoid Symptoms After Weight Loss Surgery

From the WebMD Archives

Oct. 19, 2004 -- People planning to undergo weight loss surgery may benefit from being screened and treated for a bacterium called Helicobacter pylori, say experts at Emory University.

H. pylori is the most common cause of stomach ulcers, and H. pylori infection is estimated to be present in 20%-50% of people living in industrialized countries.

Ulcers are open sores on the inner lining of the stomach. Ulcers can interfere with digestion and can cause considerable pain.

It used to be thought that stress was the cause of most stomach ulcers, but doctors now know that H. pylori infection causes most of them.

Surgery professor C. Daniel Smith, MD, who heads the division of general and gastrointestinal surgery at Emory's medical school, investigated whether infection with H. pylori might cause symptoms in patients after undergoing weight loss surgery.

In the study, Smith and colleagues studied 99 people who wanted to undergo weight loss surgery involving gastric bypass. Participants were about 40 years old on average, and they had an average body mass index (BMI) of 48, which is considered obese.All participants underwent presurgery tests, including screening for H. pylori. Almost a fourth of the patients tested positive for H. pylori. Smith's report appears in the October issue of the journal Archives of Surgery.

The researchers followed the group at one, two, six, and 12 months after their weight loss surgery.

Almost half of those that had tested positive for H. pylori had significant ulcer-related symptoms after weight loss surgery. Nausea, bloating, pain, food intolerance, and food fear affected 48% of the weight loss surgery patients who had tested positive for H. pylori.

Only 19% of participants who had not tested positive for H. pylori experienced those symptoms after their operations.

The findings suggest that screening for H. pylori and eliminating it with antibiotics might be beneficial to patients before undergoing weight loss surgery, say the researchers.

More than 120,000 weight loss operations were done in 2003, and demand for such procedures is likely to increase, they write.

Destroying H. pylori "should be considered for symptom relief and for lowering the long-term risks of ulcer disease and cancer," Smith's team concludes.

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SOURCES: Ramaswamy, A. Archives of Surgery, October 2004; vol 139: pp 1094-1096. News release, JAMA/Archives. News release, Emory Health Sciences News. WebMD Health Tools: "Body Mass Index Calculator."
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