TOPLINE:

Bariatric and metabolic surgery was associated with new-onset benign anal disorders, with constipation more common after laparoscopic sleeve gastrectomy (LSG) and diarrhea and other complications more common after laparoscopic Roux-en-Y gastric bypass (LRYGB).

METHODOLOGY:

• New-onset benign anal symptoms and disorders following bariatric and metabolic surgery are commonly observed but remain understudied.
• The cross-sectional study compared outcomes between patients who underwent bariatric and metabolic surgery (LSG vs LRYGB) and had no prior diagnosed benign anorectal disorders.
• Data were collected via questionnaires covering demographics, comorbidities, surgical details, preoperative and postoperative gastrointestinal symptoms, and the development of benign anal symptoms and disorders.
• Assessed outcomes included hemorrhoids, anal fissures, perianal fistulas, perianal abscesses, fecal incontinence, chronic diarrhea, and chronic constipation.

TAKEAWAY:

• There were 163 eligible patients (mean age, 35.5 years; 57.1% female), of whom 138 (84.7%) underwent LSG and 25 (15.3%) underwent LRYGB.
• Diarrhea was significantly more common after LRYGB than LSG (36% vs 8%; P < .001); new-onset fecal incontinence occurred in 8% vs 2.2%, respectively.
• New-onset constipation was more frequent after LSG than LRYGB (46.4% vs 28%); among patients with preexisting constipation, symptoms improved in 35.3% of LRYGB patients and 30% of LSG patients and worsened in 29.4% and 37.8%, respectively.
• Anal fissures (20% vs 11.6%), hemorrhoids (16% vs 8.7%), perianal abscess (4% vs 2.9%), and perianal fistula (8% vs 2.2%) were more common after LRYGB than LSG.
• Laxative use was higher after LSG than LRYGB (32.6% vs 16%).

IN PRACTICE:

“This study underscores the substantial burden of benign anal disorders in postbariatric patients, emphasizing that they should be recognized as predictors of patients’ quality of life,” the authors of the study wrote.

SOURCE:

The study was led by Hefzi A. Alratrout, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. It was published online in Obesity Surgery.

LIMITATIONS:

The study used an unvalidated questionnaire. The small sample size and group imbalance may have affected the results. Outcomes were self-reported, and certain symptoms (eg, malodorous stool) were not assessed.

DISCLOSURES:

No funding source was reported. The authors reported having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.