Symptoms common after gastric bypass

POSTER'S COMMENTS: "Pain and other symptoms of discomfort are hard to bear and potentially worrying. I am posting these research findings as it is reassuring to learn that a relatively benign procedure carried out in patients without a critical morbidity (IE Cancer) still leads to long term side effects similar to those which we IL survivors experience."

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Symptoms common after gastric bypass

BMJ

08 Jan 16

Although most people report feeling better after gastric bypass surgery for obesity, the majority still have symptoms five years after their procedure and nearly a third need a further hospital stay, a study has shown.

Researchers surveyed 2238 patients who underwent Roux en Y gastric bypass surgery for obesity from January 2006 to December 2011 in central Denmark and compared the patients’ self reported wellbeing and symptoms with 89 controls matched for sex and body mass index. Just under two thirds (1429; 63.7%) of patients returned the survey.

Some 87.4% of patients considered their wellbeing to be better or much better after surgery. However, 88.6% (1266 patients) reported that they had still had one or more symptoms a median of 4.7 years after their surgery.

Just over two thirds (67.7%) of patients undergoing gastric bypass had contacted the healthcare system about their symptoms. Abdominal pain was one of the most common symptoms, affecting 34.2% of patients who sought medical help. Fatigue (34.1%), anaemia (27.7%), and gallstones (16%) were also common reasons for patients contacting the healthcare system.

The risk of these symptoms was higher in women (crude prevalence ratio 1.23 (95% confidence interval 1.11 to 1.37)), patients under 35 (1.11 (1.02 to 1.20)), and those who had had these symptoms before gastric bypass surgery (1.34 (1.25 to 1.43)).

More than a quarter of patients (416; 29.1%) who had gastric bypass surgery needed a hospital inpatient admission in the five years after their procedure: 79% for surgical symptoms and 21% for medical symptoms.

“Most patients reported improved wellbeing after Roux en Y gastric bypass surgery, but the prevalence of symptoms was high,” said the researchers, led by Sigrid Bjerge Gribsholt, of Aarhus University Hospital in Denmark.

More than three quarters (78.7%) of matched controls not undergoing surgery also reported symptoms, which the study authors said may be part of the “normal” physiological features of obesity. However, these patients were much less likely to need medical help (34.8% of controls) or to be hospitalised (6.7%) than patients who had gastric surgery.

“The amount of symptoms and health care contacts after gastric bypass surgery is rather high and represents a significant burden from an individual perspective as well as for society,” the researchers concluded. “Development of new weight loss treatments with less risk of subsequent symptoms should be a high priority.”

The study was funded by the Novo Nordisk Foundation, the AP Møller Foundation, and the Research Council of the Central Denmark Region.

By Susan Mayor, London

References

1. Gribsholt SB, Pedersen AM, Svensson E, Thomsen RW, Richelsen B. Prevalence of self reported symptoms after gastric bypass surgery for obesity. JAMA Surg 2016; doi: 10.1001/jamasurg.2015.5110.

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