High Prevalence of Symptoms, Hospitalizations Observed After Gastric Bypass Surgery

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Prevalence of symptoms after gastric bypass surgery was high.
Prevalence of symptoms after gastric bypass surgery was high.

Most patients reported improved well-being after Roux-en-Y gastric bypass (RYGB) surgery, but the prevalence of subsequent symptoms like abdominal pain and fatigue was high and many patients were hospitalized, according to research published in JAMA Surgery.

Patients with morbid obesity frequently undergo bariatric surgery, including RYGB surgery, as an effective treatment method to avoid future diseases associated with obesity. Symptoms that arise after RYGB surgery can affect quality of life and could require additional treatment. Therefore, knowing the possible predictors could help prevent these symptoms after surgery.

“The amount of symptoms and health care contacts after RYGB surgery is rather high and represents a significant burden from an individual perspective as well as for society,” the authors wrote. “Nearly one-third of patients had been admitted to a hospital owing to these symptoms, mainly surgical symptoms.”

Researchers conducted a survey between March 3 and July 31, 2014, that included 2238 patients from the Central Denmark Region who underwent RYGB surgery between 2006 and 2011. The study also included a cohort of 89 individuals who did not undergo RYGB surgery, who were matched by sex and body mass index for comparison.

Of the 2238 patients, 1429 responded to the survey. Among this population, 1266 (88.6%) reported 1 or more symptoms a median of 4.7 years after surgery. Overall, 1219 of 1394 patients (87.4%) stated that their well-being was improved after gastric bypass surgery and 113 (8.1%) stated that their well-being was reduced.

The survey results showed that 966 of the 1266 patients who reported symptoms (67.6%) had contact with the health care system due to these symptoms, compared with 34.8% of the comparison group. Additionally, the hospitalization rate for the RYGB group was 29.1%, compared with 6.7% in the comparison group.

The most commonly reported symptoms that led to health care contact included abdominal pain (489 patients; 34.2%), fatigue (488 patients; 34.1%), and anemia (396 patients; 27.7%).

The researchers found that the risk for symptoms was higher among women (crude prevalence ratio [PR]=1.23; 95% CI, 1.11-1.37), patients younger than 35(PR=1.24; 95% CI, 1.13-1.36), smokers (PR=1.11; 95% CI, 1.02-1.20), unemployed individuals (PR=1.15; 95% CI, 1.06-1.24), and patients with surgical symptoms before RYGB surgery (PR=1.34; 95% CI, 1.25-1.43).

Results also indicated an inverse association between the number of symptoms and quality of life (r=-0.30; P<.001).

“Focus on the [quality of life] among patients with many symptoms may be required since such patients are at risk of depression. Development of new weight loss treatments with less risk of subsequent symptoms should be a high priority,” the authors concluded.

Reference

  1. Gribsholt SB, Pedersen AM, Svensson E, Thomsen RW, Richelsen B. Prevalence of Self-reported Symptoms After Gastric Bypass Surgery for Obesity. JAMA Surgery. 2016;doi:10.1001/jamasurg.2015.5110.
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