ORIGINAL CONTRIBUTIONS Improvement in Food Intolerance Resulting from Roux-En-Y Gastric Bypass after Speech Therapy Intervention in Chewing Débora Cardoso Rossi 1,2,3,4,5 & Aleida Nazareth Soares 6 & Kennedy Rossi Santos Silva 7,8 & Ana Teresa B. O. Britto 9 & Adriana Aparecida Bosco 6 # Springer Science+Business Media, LLC, part of Springer Nature 2019 Abstract Introduction Food intolerance is expected during the postoperative period following gastric bypass and may be associated with inadequate chewing. Objective To evaluate chewing before and after speech therapy intervention in subjects undergoing Roux-en-Y gastric bypass who present with food intolerance. Materials and Methods This was a randomized controlled trial, approved by the Brazilian Ethics and Research Committee under n. 438,600. The study population was allocated into two groups: the study group (SG), who received speech therapy intervention, and the control group (CG), who did not receive any intervention, in six visits at 7, 15, 30, 60, and 90 days (v7, v15, v30, v60, and v90) after the initial visit (v0). During v0 and v90, a chewing evaluation was performed according to the MBGR protocol adapted. The significance level adopted was 5%. Results A total of 30 females (88%) and 4 males (12%) were analyzed. The SG had 18 subjects, and the CG had 16, with mean ages of 50.17 ± 12.28 years and 45.69 ± 9.78 years, respectively. The postoperative time ranged from 4 to19 months. In the SG, a marked improvement in the number of episodes of food intolerance was observed (p < 0.001), an improvement in the intake of cereals and meats (p = 0.004 and p < 0.001, respectively), and an improvement in chewing capacity and swallowing (p = 0.002 and p = 0.011, respectively). Conclusion Speech therapy intervention in chewing led to a marked improvement of food acceptance and food intolerance resulting from Roux-en-Y gastric bypass. Keywords Bypass surgery . Food intolerance . Chewing Introduction Among the bariatric surgeries performed worldwide, the most common are Roux-en-Y gastric bypass and vertical gastrecto- my (sleeve) [1]. Both techniques restrict the gastric volume, which can lead to food intolerance of variable intensity during the early postoperative period due to the new anatomical and physiological conditions of the subject. However, if persistent, food intolerance can lead to food avoidance or improper eat- ing behavior and may result in eating habits that affect the overall quality of the diet, increase the risk of nutritional defi- ciencies, and/or compromise weight loss. Studies performed with post-surgery subjects identified dietary and nutritional problems [2–4]. The most frequent complaints during the first weeks after surgery are nausea and vomiting, but vomiting improves in 75% of subjects after 1 and 6 months [5]. Such symptoms may be associated with poor diet adherence, * Débora Cardoso Rossi deborarossi@terra.com.br 1 Institute of Education and Research Santa Casa de Misericórdia de Belo Horizonte, Domingos Vieira, 590, Belo Horizonte, MG CEP 30150240, Brazil 2 Pontifical Catholic University of São Paulo (PUCSP), São Paulo, Brazil 3 Federal Council of Speech Therapy, São Paulo, Brazil 4 Brazilian Society of Bariatric and Metabolic Surgery Associated Specialty Committee (SBCBM/COESA), São Paulo, Brazil 5 Santa Casa BH Medical Specialty Center, Belo Horizonte, Brazil 6 IEP Santa Casa BH, Belo Horizonte, Brazil 7 Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil 8 Santa Casa BH, Belo Horizonte, Brazil 9 Pontifical Catholic University of Minas Gerais (PUCMG), Belo Horizonte, Brazil Obesity Surgery https://doi.org/10.1007/s11695-019-03931-3