Gastrointestinal pH, Motility Patterns, and Transit Times After Roux-en-Y Gastric Bypass

Louise Ladebo*, Pernille V. Pedersen, Grzegorz J. Pacyk, Jens Peter Kroustrup, Asbjørn M. Drewes, Christina Brock, Anne E. Olesen

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review


Background: Studies investigating the underlying pathophysiology are needed to help explain and understand the postoperative complications following Roux-en-Y gastric bypass (RYGB) surgery. This study aimed to characterize segmental gastrointestinal pH profiles, motility measures, and transit times in patients with RYGB. Materials and Methods: Nineteen patients with RYGB underwent a standardized wireless motility capsule assessment. The oro-cecal segment was defined from capsule ingestion until the passage of the ileocecal junction. Segmental median pH, motility index, and transit time were determined for the oro-cecal and colonic segment as well as for the first and last hour of both these segments. For comparison to reference values, data from 17 healthy age- and gender-matched controls was used. A mixed effect model was used to describe differences between groups. Results: Median pH was high in patients with RYGB during the first hour of the oro-cecal segment (6.45 ± 0.4 vs 3.65 ± 1.55 pH units for healthy controls; P < 0.001), as well as during the entire oro-cecal segment (6.97 ± 0.4 vs 5.51 ± 1.1 pH units; P < 0.001). The same was evident for the median motility index (152 ± 64 vs 35.8 ± 31.1 mmHg*sec/min; P < 0.001 and 130 ± 65.9 vs 89.1 ± 20 mmHg*sec/min; P < 0.012, respectively). Median motility index was low the first hour of the colon (55.2 ± 45.7 vs 122 ± 77.9 mmHg*sec/min; P < 0.002). Additionally, patients had short oro-cecal transit time (5.8 ± 1.6 vs 7.6 ± 1.4 h; P < 0.001) and long colonic transit time (29.4 ± 17.5 vs 19.6 ± 12.2 h; P = 0.048). Conclusions: In patients with RYGB, the oro-cecal segment was characterized by an alkaline intraluminal environment, high motility activity, and short transit time. In contrast, colonic transit time was long. Graphical abstract: [Figure not available: see fulltext.]

Original languageEnglish
JournalObesity Surgery
Issue number6
Pages (from-to)2632-2640
Number of pages9
Publication statusPublished - Jun 2021
Externally publishedYes


  • Gastric Bypass
  • Gastrointestinal Motility
  • Gastrointestinal Tract
  • Gastrointestinal Transit
  • Humans
  • Hydrogen-Ion Concentration
  • Obesity, Morbid/surgery


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