Does Bariatric Surgery Improve Faecal Incontinence? A Systematic Review and Meta-analysis

Area of Science:

• Bariatric surgery
• Gastroenterology
• Pelvic floor disorders

Background:

• Obesity is a risk factor for pelvic floor disorders, including faecal incontinence (FI).
• The impact of bariatric surgery on faecal incontinence is not well-documented.
• Faecal incontinence has significant clinical and psychosocial consequences.

Purpose of the Study:

• To evaluate the effect of bariatric surgery on the prevalence and severity of faecal incontinence in adult patients with obesity.

Main Methods:

• Systematic review adhering to PRISMA guidelines.
• Searched MEDLINE, PubMed, Cochrane, and Embase (1980-2019).
• Included RCTs and observational studies assessing pre- and post-bariatric surgery FI; meta-analysis used random-effects models.

Main Results:

• Thirteen studies (678-992 patients) analyzed.
• No significant overall change in FI prevalence, but a trend towards reduction (OR=0.55, p=0.075).
• Significant FI prevalence reduction in women (p=0.034) and after Roux-en-Y/one anastomosis gastric bypass (p=0.007).
• No significant reduction in incontinence episodes or improvement in quality of life.

Conclusions:

• Bariatric surgery significantly reduces FI prevalence in women and after specific procedures (Roux-en-Y, one anastomosis gastric bypass).
• Overall FI prevalence, severity, and quality of life improvements were not statistically significant.
• Larger studies are required to confirm the true effect of bariatric surgery on faecal incontinence.