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Published on: October 29, 2014
New-onset Anorectal Symptoms and Disorders After Bariatric Surgery: An Overlooked Entity
Hefzi A Alratrout1, Hitaf A Alqadoum2, Sarah S Almutairi2
1Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Background:
Bariatric and metabolic surgery (BMS) in Saudi Arabia is increasing. Many patients suffer from postoperative altered bowel habits and anorectal disorders. Development of new-onset benign anal symptoms and disorders (NBADs) after BMS is commonly seen in daily clinical practice. However, the literature lacks studies on this overlooked entity. Therefore, we aim to assess the incidence of NBADs in patients who underwent BMS in the Eastern Province of Saudi Arabia.
Methods:
In this cross-sectional questionnaire-based study, a questionnaire was distributed to all patients who had undergone any type of BMS at our tertiary university hospital or during various obesity awareness campaigns held during 2024.
Results:
The 163 patients enrolled were categorized into group I (138 patients after laparoscopic sleeve gastrectomy (LSG) and group II (25 patients after laparoscopic Roux-en-Y gastric bypass (LRYGB). The results showed new-onset diarrhea was significantly more common after LRYGB (8% vs. 36%), and new-onset fecal incontinence was also reported (2.2% vs. 8%). New-onset constipation was reported (46.4% vs. 28%), and pre-existing constipation improved (30% vs. 35.3%) and worsened (37.8% and 29.4%) in both groups, respectively. New-onset anal fissure, new-onset hemorrhoids, new-onset perianal abscess, and perianal fistula were reported (11.6% vs. 20%), (8.7% vs. 16%), (2.9% vs. 4%), (2.2% vs. 8%), in group II and group II, respectively.
Conclusion:
This study underscores the substantial burden of benign anal symptoms and disorders in post-bariatric patients. Constipation is more common after LSG, whereas LRYGB is associated with a higher incidence of newly developed diarrhea, fecal incontinence, anal fissure, hemorrhoids, perianal fistula, and abscess.
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