Høgestøl Ingvild K, Chahal-Kummen Monica, Eribe Inger, Brunborg Cathrine, Stubhaug Audun, Hewitt Stephen, Kristinsson Jon, Mala Tom
Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Obes Surg. 2017 Jun;27(6):1438-1445. doi: 10.1007/s11695-016-2499-z.
Roux-en-Y gastric bypass (RYGB) is widely performed as treatment of morbid obesity. Long-term weight loss, effects on co-morbidities, and quality of life after RYGB have been well addressed. Other long-term outcomes are less elucidated. The aim of this study was to evaluate the prevalence, symptom characteristics, and possible predictors of chronic abdominal pain and gastrointestinal symptoms during consultations 5 years after RYGB.
A 5-year follow-up study of patients operated with RYGB 2008-2009 was performed. The patients completed questionnaires regarding chronic abdominal pain, the Gastrointestinal Symptom Rating Scale (GSRS), the ROME III questionnaire, the Hospital Anxiety and Depression Scale, Pain Catastrophing Scale (PCS), the Brief Pain Inventory, and SF-36. Uni- and multivariable logistic regression analyses of characteristics associated with chronic abdominal pain were performed.
A total of 165/234 (71%) patients met to the follow-up, 160 of these accepted study inclusion. The mean follow-up was 64 (SD 4.2) months. The mean age was 42.5 (SD 8.7) years and 59% were females. The mean total weight loss was 23.9% (SD 11.2). Chronic abdominal pain was reported by 33.8%. Female gender, average strength of bodily pain, and the PCS sum score were associated with chronic abdominal pain. Symptoms of indigestion and irritable bowel syndrome were reported by 48.8% and 29.1%, respectively. Chronic abdominal pain was associated with reduced health related quality of life.
A substantial proportion of patients experienced chronic abdominal pain and symptoms 5 years after RYGB. Abdominal pain should be addressed at follow-up consultations after RYGB.
Roux-en-Y胃旁路术(RYGB)作为病态肥胖的治疗方法被广泛应用。RYGB术后的长期体重减轻、对合并症的影响以及生活质量已得到充分研究。其他长期结局则较少被阐明。本研究的目的是评估RYGB术后5年门诊时慢性腹痛和胃肠道症状的患病率、症状特征以及可能的预测因素。
对2008年至2009年接受RYGB手术的患者进行了为期5年的随访研究。患者完成了关于慢性腹痛、胃肠道症状评分量表(GSRS)、罗马III问卷、医院焦虑抑郁量表、疼痛灾难化量表(PCS)、简明疼痛问卷和SF-36的问卷调查。对与慢性腹痛相关的特征进行了单变量和多变量逻辑回归分析。
共有165/234(71%)例患者接受了随访,其中160例接受了研究纳入。平均随访时间为64(标准差4.2)个月。平均年龄为42.5(标准差8.7)岁,59%为女性。平均总体重减轻了23.9%(标准差11.2)。33.8%的患者报告有慢性腹痛。女性性别、身体疼痛的平均强度和PCS总分与慢性腹痛相关。分别有48.8%和29.1%的患者报告有消化不良和肠易激综合征症状。慢性腹痛与健康相关生活质量下降有关。
相当一部分患者在RYGB术后5年出现慢性腹痛和症状。RYGB术后随访门诊应关注腹痛问题。