Gastrointestinal Symptomatic Outcome after Laparoscopic Roux-en-Y Gastric Bypass for Morbid Obesity
Abstracts
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Background: Little information is available regarding the gastrointestinal (GI) symptomatic outcome after laparoscopic Roux-en-y gastric bypass (LRY) for morbid obesity. The purpose of this study is to identify changes occuring in GI symptoms after LRY. Methods: Patients considered for LRY complete a previously validated GI symptom questionnaire at initial consultation. The survey consists of 19 symptoms, and the patient rates the degree to which each symptom affects their life on a scale of 0-100. The same survey is re-administered 6 months postoperatively. The mean of each symptom (preop vs. postop)is compared using Students t-test with significance p<.05. Results: 43 preop and 35 postop (81% follow-up) patients age 37.4 yrs with BMI 47.8 completed the questionnaire. Results of each symptom is expressed as mean ? standard deviation of preop vs. postop scores. Significantly different symptoms include: abdominal pain 23.3 ? 26.4 vs 8.6 ? 13.5, p=.003; heartburn 34.0 ? 26.6 vs. 8.0 ? 14.0, p=.0001; acid regurgitation 28.1 ? 24.0 vs. 10.7 ? 21.0, p=.001; gnawing in epigastrium 19.3 ? 22.7 vs. 7.5 ? 16.0, p=.01; abdominal distention 38.2 ? 31.5 vs. 11.1 ? 19.2, p<.0001; eructation 27.7 ? 24.4 vs. 15.5 ? 26.9, p=.01; increased flatus 40.2 ? 25.7 vs 25.2 ? 25.3, p=.005; decreased stools 5.4 ? 16.8 vs 17.4 ? 20.0, p=.0005; increased stools 23.9 ? 26.7 vs. 6.5 ? 11.7, p<.0005; loose stools 29.7 ? 26.5 vs. 17.5 ? 20.0, p=.03; urgent defecation 34.3 ? 26.5 vs. 14.3 ? 19.3, p=.0009; difficulty falling asleep 44.1 ? 38.4 vs. 27.5 ? 32.9, p.05; insomnia 42.4 ? 36.2 vs. 21.6 ? 30.5, p=.008; rested upon awakening 65.1 ? 33.8 vs. 30.5 ? 28.8, p<.0001. Symptoms that did not significantly change include: nausea/vomiting 17.2 ? 22.7 vs. 22.1 ? 19.9, p=.33; borborygmus 28.8 ? 25.2 vs.26.8 ? 29.7, p=.75; hard stools 10.3 ? 22.9 vs. 7.1 ? 18.6, p.56; incomplete evacuation of stool 17.2 ? 22.8 vs. 13.4 ? 21.7, p=.45; dysphagia 10.9 ? 15.6 vs. 17.7 ? 28.4, p=.18. Conclusion: LRY significantly improves many gastrointestinal symptoms experienced by morbidly obese patients without adversely effecting any of the measured parameters. This information is useful in preopoerative counseling to assure patients of overall symptomatic improvement after this operation. |
