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Updated: Jun 29, 2026

E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Preoperative patient education on constipation management reduces healthcare utilization following bariatric surgery
Arthur A Cross-Najafi1, Ryan Kuhn1, Julia B Alexieva1
1Rush University Medical Center, Chicago, United States; Department of Surgery, Division of Minimally Invasive and Bariatric Surgery, United States.
Introduction:
Constipation following bariatric surgery decreases patient satisfaction and quality of life while increasing healthcare utilization. We evaluate the impact of a preoperative educational handout on constipation-related communication (CRC) and emergency department (ED) visit frequency.
Methods:
Adult patients who underwent bariatric surgery between 2022 and 2023 who either received or did not receive the handout were analyzed. Baseline demographics, medical comorbidities, and rates of CRC and ED visits within 180 days postoperatively were compared using inferential statistics. Number needed-to-treat (NNT) analyses were performed.
Results:
400 patients were included (n = 176 No Handout, n = 224 Handout). Baseline characteristics were comparable. CRCs decreased from 18.8% to 9.4% (p = 0.006), and ED visits decreased from 5.7% to 1.8% (p = 0.035). The NNT for CRC and ED visits were 11 and 26 handouts, respectively.
Conclusions:
Implementation of a low-cost preoperative educational handout significantly reduced postoperative healthcare use, representing a high-value intervention to improve patient outcomes and reduce system burden.
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