system
Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Body Mass Index, Female, Follow-Up Studies, Gastric Acid, Gastric Acidity Determination, Gastric Bypass, Gastroesophageal Reflux, Humans, Laparoscopy, Male, Obesity, Morbid, Postoperative Care, Proton Pump Inhibitors, Retrospective Studies, Time Factors, Weight Loss.
user
Are acid suppression medications associated with suboptimal weight loss after laparoscopic Roux-en-Y gastric bypass in patients older than 40 years? Context: Bariatric surgery, including laparoscopic Roux-en-Y gastric bypass (LRYGB), achieves the greatest long-term weight loss in severe obesity. Approximately 50%-60% of severely obese patients have gastroesophageal reflux disease, and a substantial proportion is taking a proton pump inhibitor (PPI) or histamine-2 blocker (H2 B) at the time of LRYGB. The objective of this study was to explore the association of PPI/H2 B use before LRYGB with suboptimal percent weight loss (PWL) after LRYGB. This was a cohort study of 472 consecutive patients who underwent LRYGB at a single center from 2004-2011. Suboptimal PWL was defined as<14% at 2 months,<25% at 6 months, and<30% at 12 months. Because of effect modification by age, stratified analyses (by median age of 40 yr) were performed. All models were adjusted for appropriate covariates, including obesity-associated co-morbidities. For patients aged ≤40 years, PPI/H2 B use leading up to LRYGB was not associated with suboptimal PWL at 2 months (P = .86), 6 months (P = .47), or 12 months (P = .66). However, for patients aged>40 years, PPI/H2 B use leading up to LRYGB was associated with a nonsignificant increase in suboptimal PWL at 2 months (odds ratio [OR] 2.23; P = .08) and significant increases in suboptimal PWL at 6 months (OR 7.23; P = .002) and 12 months (OR 11.1; P = .02). Results were independent of GERD.
assistant
Mechanisms for the poorer weight loss in patients aged>40 years who were using a PPI/H2 B just before LRYGB should be explored. Final Decision: yes