Chronic Abdominal Pain After Roux-en-Y Gastric Bypass Surgery: A Prospective Cohort Study with 2-Year Follow-Up in a Swedish Population.

Abstract

Background: The risk of developing chronic abdominal pain after Roux-en-Y gastric bypass (RYGB) surgery has come under scrutiny. Few prospective studies exist on this subject. The aim of this prospective paired analysis cohort study was to evaluate the risk of developing chronic abdominal pain and QoL 2 years after RYGB surgery.

Methods: An unselected cohort of 107 patients living with obesity, scheduled to undergo elective RYGB surgery, filled out the study questionnaires before surgery. Two years after surgery, 84 patients responded to the questionnaires, resulting in a response rate of 78.5%.

Results: The gastrointestinal symptom rating scale showed no change for diarrhea, indigestion, or obstipation, but on the other hand, a tendency to increased abdominal pain (p = 0.05) 2 years after RYGB. Gastroesophageal reflux symptoms decreased (2.1 ± 1.3 to 1.4 ± 0.9; p < 0.0001). Pain anxiety using the Pain Catastrophizing Scale decreased (from 13.5 ± 11.3 preoperatively to 10.1 ± 9.4 postoperatively, p = 0.001). The Hospital Anxiety and Depression Scale showed a decreased score for depression (4.4 ± 3.7 to 2.4 ± 3.3, p < 0.0001), but no change for anxiety. Quality of life increased significantly (EQ5D-3L health state from 0.69 ± 0.25 to 0.83 ± 0.23, p < 0.0001; EQ VAS: from 57.4 ± 19.6 to 80.1 ± 16.3, p < 0.001). Self-reported physical activity, according to the Saltin-Grimby Physical Activity Level Scale (SGPALS), increased (preoperative: median = 2, Q1 = 1, Q3 = 2; postoperative: median = 2, Q1 = 2, Q3 = 2.75, p < 0.0001).

Conclusions: Our study indicates no significant increase in abdominal pain but decreased pain anxiety 2 years after RYGB surgery. Self-reported physical activity, depression symptoms, and general quality-of-life were improved compared to baseline values.