Rethinking Post-Bariatric Care: Anorectal Morbidity Following Sleeve Gastrectomy and Roux-en-Y Gastric Bypass

Area of Science:

• Gastroenterology
• Bariatric Surgery
• Anorectal Health

Background:

• Bariatric surgery is effective for morbid obesity but its impact on anorectal health is under-investigated.
• Common anorectal conditions include anal fissures and hemorrhoids.
• Understanding post-surgical morbidities is crucial for patient management.

Purpose of the Study:

• To evaluate the incidence and severity of anal fissures and hemorrhoids after sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB).
• To identify risk factors for post-bariatric surgery anorectal complications.

Main Methods:

• Retrospective cohort study of 280 patients (200 SG, 80 RYGB) from 2015-2023.
• Analysis of pre- and post-operative anorectal conditions, bowel habits, and surgical outcomes.
• Statistical analysis including multivariate analysis to identify independent predictors.

Main Results:

• RYGB group had a significantly higher incidence of new-onset anorectal disorders (47.5% vs. 32.5% in SG group).
• RYGB was associated with increased frequency and severity of hemorrhoids and anal fissures.
• Post-operative constipation and RYGB were independent predictors of anorectal disorders.

Conclusions:

• Roux-en-Y gastric bypass (RYGB) carries a higher risk of anorectal complications compared to sleeve gastrectomy (SG).
• Proactive assessment and management of anorectal health are essential in post-operative bariatric surgery care.
• Bowel habit regulation and symptom monitoring are key to optimizing patient well-being.