In the Journals

Gastric bypass surgery yields high rate of symptoms, hospitalization

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January 7, 2016

Most Danish patients with obesity who underwent Roux-en-Y gastric bypass reported better well-being overall in the years after surgery, despite many patients reporting one or more symptoms that led to health care contact or hospitalization, according to research in JAMA Surgery.

Sigrid Bjerge Gribsholt, MD, of Aarhus University Hospital in Denmark, and colleagues analyzed data from 1,429 Danish patients who underwent Roux-en-Y gastric bypass (RYGB) between 2006 and 2011 (20% men; mean time since surgery, 4.7 years; mean age at time of survey, 47 years; mean BMI after surgery, 29.7 kg/m²) and responded to a questionnaire regarding postoperative surgical symptoms (abdominal pain, kidney stones, gallstones), medical and nutritional symptoms (diarrhea, anemia, fatigue, neurologic symptoms, dumping and hypoglycemia) and the presence of symptoms before surgery. Patients were asked whether each symptom led to any contact with the health care system, and they were categorized as no contact, any contact, and contact with secondary care only or hospital admission. Quality-of-life measures were assessed via the mental composite score and the physical composite score. A comparison cohort of 89 adults who did not undergo RYGB were recruited via the Internet and were matched according to sex and BMI (22.5% men; mean age, 38 years; mean BMI, 29.4 kg/m²); the control group also responded to the questionnaire.

Within the cohort, 87% (n = 1,219) reported improved well-being (feeling “better” or “much better”) after surgery; however, 89% (n = 1,266) reported one or more symptoms after surgery vs. 79% of controls (n = 70) who also reported experiencing symptoms. The most commonly reported symptoms among the RYGB cohort were fatigue (54%), abdominal pain (54%) and dumping (52%); 68% of patients reported symptoms leading to any health care contact vs. 35% for controls. Within the RYGB group, 29% reported symptoms leading to hospitalization vs. 7% of controls.

The risk for symptoms was higher among women (prevalence ratio [PR] = 1.23; 95% CI, 1.11-1.37), patients younger than 35 years (PR = 1.24; 95% CI, 1.13-1.36), smokers (PR = 1.11; 95% CI, 1.02-1.2), unemployed patients (PR = 1.15; 95% CI, 1.06-1.24) and in those with surgical symptoms before RYGB surgery (PR = 1.34; 95% CI, 1.25-1.43). Quality of life was inversely associated with the number of symptoms, according to researchers.

“Those who reported worse well-being were characterized by a high prevalence of symptoms,” the researchers wrote. “Obesity is associated with reduced [quality of life], possibly owing to stigmatization, reduced mobility and obesity-related diseases. Satisfaction with weight loss after RYGB surgery may outweigh some dissatisfaction with symptoms after surgery.” – by Regina Schaffer

Disclosure: The researchers report no relevant financial disclosures.