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Observational Study
. 2023 Aug;19(8):819-829.
doi: 10.1016/j.soard.2023.01.020. Epub 2023 Feb 1.

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  1 , Villy Våge  2 , Jon A Kristinsson  3 , Tom Mala  4
Affiliations
Free article
Observational Study

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 et al. Surg Obes Relat Dis. 2023 Aug.
Free article

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.

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