Gastrointestinal symptoms in relation to quality of life after metabolic surgery in adolescents

Lindel Dewberry; Jane Khoury; Sarah Schmiege; Todd Jenkins; Richard Boles; Thomas Inge

doi:10.1016/j.soard.2019.12.025

Gastrointestinal symptoms in relation to quality of life after metabolic surgery in adolescents

Surg Obes Relat Dis. 2020 Apr;16(4):554-561. doi: 10.1016/j.soard.2019.12.025. Epub 2020 Jan 3.

Authors

Lindel Dewberry¹, Jane Khoury², Sarah Schmiege³, Todd Jenkins², Richard Boles⁴, Thomas Inge⁵

Affiliations

¹ Department of Surgery, University of Colorado, Aurora, Colorado. Electronic address: lindel.kring@gmail.com.
² Department of Statistics, Cincinnati Children's Hospital, Cincinnati, Ohio.
³ Department of Biostatistics, University of Colorado, Aurora, Colorado.
⁴ Department of Psychology, Children's Hospital Colorado, Aurora, Colorado.
⁵ Department of Surgery, Children's Hospital Colorado, Aurora, Colorado.

Abstract

Background: Adolescent obesity is associated with significant co-morbidities, including decreased quality of life (QOL). QOL improves after metabolic and bariatric surgery (MBS), but recent studies have demonstrated that certain gastrointestinal symptoms (GIS) worsen after surgery, including reflux symptoms, nausea, bloating, and diarrhea.

Objective: The aim of this study was to evaluate QOL and the effect of these symptoms on QOL after bariatric surgery.

Setting: Five academic centers that perform adolescent MBS in the United States.

Methods: We prospectively studied 228 adolescents undergoing MBS using the Teen-Longitudinal Assessment of Bariatric Surgery cohort. GIS and QOL scores were assessed before surgery, at 6 months, and yearly to 5 years after surgery. Analysis involved linear models examining QOL and the association between GIS and QOL adjusting for a priori determined covariates.

Results: Adjusting for body mass index change over time, the physical component score (PCS) of the Short Form-36 (SF-36) increased after surgery from 44.2 at baseline to 54.4 at 5 years (P < .0001). The mental component score did not significantly change over time. The SF-36 domains that showed the biggest increase after surgery were physical functioning, physical role functioning, and general health. The SF-36 PCS decreased significantly over time post surgery in those with GIS of reflux, nausea, and diarrhea but remained higher than baseline SF-36 PCS. There was no statistically significant change in mental component score or impact of weight on quality of life-KIDS scores in those with or without GIS.

Conclusion: QOL, specifically the SF-36 PCS, increases after MBS. Reflux symptoms, nausea, and diarrhea reduce the degree of improvement in QOL in adolescents after MBS. Patients should be monitored and treated for these symptoms to address this decreased QOL.

Keywords: Adolescent bariatric surgery; Gastrointestinal symptoms; Quality of life.

MeSH terms

Adolescent
Bariatric Surgery* / adverse effects
Cohort Studies
Gastroesophageal Reflux*
Gastrointestinal Diseases* / etiology
Gastrointestinal Diseases* / surgery
Humans
Quality of Life

Abstract

MeSH terms

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