Incidence of benign anal diseases after bariatric surgery

Abstract

Due to the altered bowel habits after bariatric surgery (BS), we hypothesize that there is a high frequency of benign anal diseases (BAD) in these patients. We aimed to assess the incidence of BAD in patients that underwent BS and the factors associated with its development. A retrospective review of the patient's records with morbid obesity that underwent BS at a single institution from 2010 to 2016 was conducted. Two-hundred thirty-five patients who underwent BS were included. Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) was performed in 210 (89.4%) and 25 (10.6%) patients, respectively. The total follow-up was 804.3 person-years. The mean postoperative follow-up was 41 months (95% CI: 38–44.1). At follow-up, normal bowel habits were found in 186 (79.2%) patients, constipation in 36 (15.3%), and diarrhea in 13 (5.5%). BAD occurred in 9 (3.8%) patients; hemorrhoids were diagnosed in 6 (2.5%) and abscess/fistulae in 3 (1.3%). There was no predominance of BAD regarding sex (2.9% females Vs. 6.2% males, p = 0.237) or BS performed (3.8% RYGB Vs. 4% SG, p = 0.963). Postoperative weight change was not associated with BAD. Patients who developed BAD after BS were older (median 52 Vs. 45 years, p = 0.011) and had fewer bowel movements per day (median 1 Vs. 2, p < 0.001). All patients with BAD had constipation after BS in comparison to 11.9% of patients without BAD ( p < 0.001). In the logistic regression analysis only the age was associated to the development of BAD (p = 0.033). The frequency of BAD after BS was 3.8% over a mean follow-up time of 41 months. The estimated incidence density of BAD after BS was 11.1 events per 1000 person-years. Older age was associated with its occurrence. • The frequency of development of benign anal disorders (BAD) after a bariatric surgery (BS) is scarcely studied. • The frequency of BAD after BS was 3.8% during a mean follow-up time of 41 months. • The estimated incidence density of BAD after BS was 11.1 events per 1,000 person-years. • The type of bariatric surgery or the modification of the bowel habit after surgery does not affect the incidence of BAD.