Chronic abdominal pain and quality of life after Roux-en-Y gastric bypass and sleeve gastrectomy - a cross-cohort analysis of two prospective longitudinal observational studies

Monica Chahal-Kummen; Villy Våge; Jon A Kristinsson; Tom Mala

doi:10.1016/j.soard.2023.01.020

Chronic abdominal pain and quality of life after Roux-en-Y gastric bypass and sleeve gastrectomy - a cross-cohort analysis of two prospective longitudinal observational studies

Surg Obes Relat Dis. 2023 Aug;19(8):819-829. doi: 10.1016/j.soard.2023.01.020. Epub 2023 Feb 1.

Authors

Monica Chahal-Kummen¹, Villy Våge², Jon A Kristinsson³, Tom Mala⁴

Affiliations

¹ Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway. Electronic address: monichalkum@outlook.com.
² Scandinavian Obesity Surgery Registry, Department of Gastrointestinal Surgery, Haukeland University Hospital, Bergen, Norway.
³ Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.
⁴ Department of Endocrinology, Morbid Obesity and Preventive Medicine and Department of Pediatric and Gastrointestinal Surgery, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

PMID: 36870870
DOI: 10.1016/j.soard.2023.01.020

Abstract

Background: Chronic abdominal pain (CAP) after bariatric surgery is not extensively explored and may impact the postoperative outcomes.

Objective: To compare the prevalence of patient-reported chronic abdominal pain (CAP) after Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). Secondarily, we compared other abdominal and psychological symptoms and quality of life (QoL). Preoperative predictors of postoperative CAP were also explored.

Setting: Tertiary referral centers for bariatric surgery in Norway.

Methods: Analyses of 2 separate prospective longitudinal cohort studies evaluating CAP, abdominal and psychological symptoms and QoL before and 2 years after RYGB and SG.

Results: Follow-ups were attended by 416 patients (85.8%), 300/416 (72.1%) were females and 209/416 (50.2%) were RYGB procedures. At follow-up, the mean age was 44.9 (10.0) years, BMI 29.5 (5.4) kg/m², and total weight loss 31.6 (10.3) %. The prevalence of CAP was 28/236 (11.9%) before and 60/209 (28.7%) after RYGB (P < .001) and 32/223 (14.3%) before and 50/186 (26.9%) after SG (P < .001). Gastrointestinal symptom rating scale scores showed greater deterioration of diarrhea and indigestion after RYGB and reflux after SG. The improvement in depression symptoms was greater after SG, as well as several QoL scores improved more after SG. Patients with CAP after RYGB experienced deterioration in several QoL scores, while these scores improved in patients with CAP after SG. Preoperative hypertension, bothersome reflux symptoms, and CAP predicted postoperative CAP.

Conclusions: The prevalence of CAP increased comparably after RYGB and SG, with worsening of gastroesophageal reflux after SG and greater deterioration of diarrhea and indigestion after RYGB. In patients with CAP at follow-up, several QoL scores improved more after SG than RYGB.

Keywords: Anxiety; Chronic abdominal pain; Depression; Gastrointestinal symptoms; Outcomes; Predictors; Quality of life; Roux-en-Y gastric bypass; Sleeve gastrectomy.

Publication types

Observational Study

MeSH terms

Abdominal Pain / epidemiology
Abdominal Pain / etiology
Adult
Diarrhea
Dyspepsia*
Female
Gastrectomy / adverse effects
Gastric Bypass* / adverse effects
Gastroesophageal Reflux*
Humans
Longitudinal Studies
Male
Middle Aged
Prospective Studies
Quality of Life