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Obesity and GI Disorders

The World Health Organization (WHO) estimated that 1.5 billion adults were overweight in 2008 with a body mass index (BMI) of 25 kg/m2 or higher [18]. The Centers for Disease Control and Prevention in 2013 ranked the U.S. population in 2009-2010 as 69.2% overweight and 35.9% obese [19]. GI disorders have a high prevalence in this population [20].

Gut inflammation caused by cytokines can influence mood and cognition as well as alterations in the stomach and intestines presenting as IBS, gastroesophageal reflux disease (GERD), ulcers, or Crohn’s disease, which can be secondary disorders to obesity. These inflammatory diseases can be caused from food intolerances and/or inadequate microbiota balance.

Many bariatric candidates present with bloating and abdominal pain after eating. Common triggers to digestive inflammation are grain and dairy foods. Since the gut contains an estimated 70%-80% of the immune system, this represents the largest contact area that the human body has with the external world. The lymphoid tissue surrounding the intestines—the gut associated lymphoid tissue (GALT)—forms the largest immune organ in the body.

A continuous intake of reactive substances causes inflammation in the intestinal tissue, which spreads to other tissues affecting the hormonal and nervous system [21]. Food intolerances can be caused by poor diet habits, stress, and fatigue and can be associated with elevated inflammation markers like C-reactive protein (CRP). Lactose, gluten, and fructose intolerances can be due to an enzyme deficiency while celiac disease is a genetic factor [22].

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