Incidence of benign anal diseases after bariatric surgery

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AimDue 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. MethodA retrospective review of the patient's records with morbid obesity that underwent BS at a single institution from 2010 to 2016 was conducted. ResultsTwo-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). ConclusionThe 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.