Gastrointestinal Symptoms and Health-Related Quality of Life Following Metabolic Bariatric Surgery: A Prospective Cohort Study.

BACKGROUND

Weight loss and improvement in health-related quality of life (HRQoL) following metabolic bariatric surgery (MBS) are well documented. However, there is varied and inconclusive data on postoperative gastrointestinal symptoms.

METHODS

A prospectively maintained database of patients in a regional hospital undergoing laparoscopic sleeve gastrectomy (LSG), Roux-en-Y gastric bypass (RYGB) and one-anastomosis gastric bypass (OAGB) between March 2018 and August 2019 was retrospectively analysed. Gastrointestinal symptoms and HRQoL were measured over 2 years using the Structured Assessment of Gastrointestinal Symptoms Scale (SAGIS) and Short Form 36 (SF-36) standardised health questionnaires, respectively.

RESULTS

A total of 203 patients were included for analysis. There was an improvement in median total symptom burden score from 5.5 to 4.0 at 24 months (p = 0.010). Constipation scores did not change. Nausea and vomiting worsened in the first 6 months (p < 0.001) and then improved back to baseline by 24 months (p = 0.003). Diarrhoea and discomfort scores improved from baseline to 24 months (p = 0.022). Epigastric pain improved from baseline to 24 months (p = 0.021). Median reflux score did not change between 0 and 6 months and then improved to significantly better than baseline at 24 months (p = 0.040). All three surgeries demonstrated sustained weight loss to 24 months. Overall HRQoL and each of the eight domains significantly improved post-surgery.

CONCLUSION

There was an overall improvement in gastrointestinal symptoms post-surgery. The data reaffirmed sustained weight loss and improvement in HRQoL post MBS.