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Background and Objectives: The prevalence of GERD is increasing among individuals with obesity, and RYGB is an effective procedure to control GERD and obesity. However, some patients continue to have GERD after RYGB. The aim of this study was to investigate the prevalence and the risk factors for GERD after RYGB. Material and Methods : This prospective study included 180 RYGB patients followed for an average of 12.2 (0.6) years. In total, 126 (70%) patients agreed to participate and provided data on their weight, GERD symptoms, and filled the GERD-HRQL, TFEQ-18, and GSRS questionnaires. Results: The average age before surgery was 42.7 (10.5) years, and BMI was 45.2 (6.4) kg/m 2 . Moreover, 128 (71.1%) were females, and preoperative GERD was diagnosed in 74 (41.1%) patients. At the 12-year follow-up, the mean %EBMIL and %TWL was 60.37 and 25.73, respectively. The median %WR was 18.0 (39.0). Postoperative GERD was present in 30 (23.8%) patients, of whom 12 (40%) continued to have GERD symptoms and 18 (60%) developed de novo GERD. The GERD-HRQL score significantly decreased from 3.0 (9.0) at baseline to 2.0 (5.0) ( p = 0.028) at 12 years. GSRS Diarrhea and Indigestion scores increased significantly from 1.33 (0.67) to 1.5 (2.42) ( p < 0.001) and from 2.0 (1.25) to 2.25 (1.25) ( p < 0.001), respectively. No change in the cognitive restraint score was observed. Uncontrolled eating and emotional eating scores decreased from 51.85 (22.22) to 40.74 (33.33) ( p < 0.001) and from 44.44 (44.44) to 33.33 (22.22) ( p < 0.001), respectively. In the multivariate analysis, %WR > 11 (OR = 3.22, p = 0.029) and GSRS Diarrhea score (OR = 3.21, p = 0.027) were significant predictors of GERD 12 years after RYGB. Conclusions: RYGB was an effective procedure to control GERD; however, 23.8% had persistent or de novo GERD after 12 years. The independent risk factors associated with GERD after RYGB were weight regain and GSRS Diarrhea score.

Background: Scarce evidence exists in the literature about the factors influencing the long-term quality of life (QoL) and weight regain (WR) after Roux-en-Y gastric bypass (RYGB). The aim of the present study was to investigate factors associated with WR and QoL, measured by obesity specific Moorehead-Ardelt Quality of Life Questionnaire II (M-A QoLQ II), 12 years after RYGB., Methods: This prospective longitudinal cohort study included 74 patients with obesity who had RYGB at the Lithuanian University of Health Sciences hospital Surgery department in 2005. Gastrointestinal and dumping symptoms, hypoglycemia, depression and anxiety disorders, hunger, satiety after meals, portion size, and grazing were assessed in the patients who agreed to participate in the study. General linear models were constructed to estimate the effect of variables on the WR and QoL., Results: 12-year follow-up data were available for 50 patients (38 female, median body mass index (BMI) before surgery 42.4). The mean % excess BMI loss (%EBMIL) after 12 years was 63.1 (24.6) and the average %WR was 32.2 (19.4). The mean M-A QoLQ II score was 1.44 (1.3). Majority of the patients (76.6%) reported good or very good QoL. In multivariable analysis, only grazing (17.41% 95% CI 7.61-27.21; P = 0.001) was found to be a significant independent factor associated with WR. Factors independently associated with worse QoL were grazing (- 0.97 95% CI - 1.72, - 0.22; P = 0.013) and frequency of abdominal pain once or more per month (- 1.82 95% CI - 2.79, - 0.85; P = 0.001)., Conclusion: 12 years after RYGB majority of the patients report good or very good QoL and despite some WR have achieved and maintained significant weight loss. Grazing was associated with both WR and worse QoL, while the frequency of abdominal pain once or more per month was associated with only decreased QoL., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)