The effect of ultra-processed food reduction in an attempt to control abdominal pain after Roux-Y gastric bypass: A retrospective cohort study

BACKGROUND: Numerous patients encounter unexplained abdominal pain following Roux-en-Y gastric bypass, for which standard dietary treatments prove ineffective. Therefore, a step-by-step dietary approach was developed: 1) treatment of dumping syndrome, 2) elimination and reintroduction of lactose and fructose, 3) exclusion products with added sugar, 4) exclusion artificial sweeteners. The aim of this study is to examine the effect of this approach on abdominal pain. METHODS: This retrospective study analyzed all patients treated with the step-by-step approach. Group 1 (n = 31) consisted of patients who were pain-free after the step-by-step approach, and compared with group 2 (n = 36), consisting of patients with persistent abdominal pain. RESULTS: All patients in group 1 were pain-free after the step-by-step approach, compared to 0% in group 2 (P ≤ 0.001). Remarkably, patient adherence to dietary treatment via the step-by-step approach, in group 1, was 100%, in comparison to group 2, where it was 8.3% (P ≤ 0.001). Additionally, there was a significant difference in psychological issues at baseline (P = 0.032) in favor of the patients in group 1. CONCLUSIONS: The step-by-step dietary approach seems to be effective in managing abdominal pain after Roux-en-Y gastric bypass. Notably, significant differences were observed in patient adherence to the dietary approach and the presence of psychopathology, which unfavorably affects patients with persistent complaints. This implies that patient adherence and psychopathology likely influence the impact on abdominal discomfort. Further research is necessary to validate these findings.