A prospective longitudinal study of chronic abdominal pain and symptoms after sleeve gastrectomy

Surg Obes Relat Dis. 2021 Jul 28;S1550-7289(21)00357-9. doi: 10.1016/j.soard.2021.07.014. Online ahead of print.

Abstract

Background: Sleeve gastrectomy (SG) is widely applied. Few studies have evaluated patient-reported abdominal symptoms after SG.

Objective: To evaluate the prevalence of chronic abdominal pain (CAP) and symptom characteristics after SG.

Setting: Oslo University Hospital and Voss Hospital.

Methods: We performed a longitudinal prospective cohort study of patients operated on with SG at two tertiary referral centers. For broad assessments of abdominal pain and symptoms, consultations were performed and questionnaires retrieved before and 2 years after SG. The definition of CAP or recurrent abdominal pain lasting for more than 3 months was sustained. Preoperative predictors of CAP were explored.

Results: Of 249 patients at baseline, 207 (83.1%) had follow-up consultations. Mean preoperative body mass index was 43.9 (6.0) kg/m2, and 181 patients (72.7%) were female. Total weight loss was 31.9% (10.4%). CAP was reported in 32 of 223 patients (14.3%) before and in 50 of 186 patients (26.9%) after SG (P =.002). All mean gastrointestinal symptoms rating scale questionnaire scores increased after SG, and they were higher in patients with CAP. Symptoms of depression decreased but were more prevalent in patients with CAP at follow-up. Most quality-of-life scores increased after SG. However, patients with CAP had lower scores (except for physical functioning). Preoperative bothersome Gastrointestinal Symptom Rating Scale reflux symptoms, study center, and younger age seemed to predict CAP after SG.

Conclusion: The prevalence of patient-reported CAP increased after SG. Patients reporting CAP had reduced quality-of-life scores.

Keywords: Anxiety; Bariatric surgery; Chronic abdominal pain; Depression; Gastrointestinal symptoms; Quality of life; Sleeve gastrectomy.