Changes in bowel habits after laparoscopic sleeve gastrectomy

Introduction
Bariatric surgery has a significant impact on dietary intake, weight loss, patient’s metabolism and also on defaecation stereotypes.

Aim
To investigate changes in bowel habits of morbidly obese patients after laparoscopic sleeve gastrectomy (LSG).

Material and methods
This was a prospective clinical cohort study conducted to assess changes in bowel habits after LSG in a single institution.

Results
In total, 124 patients were enrolled in the study (age 47.1 ±11.2 years, body mass index (BMI) 44.3 ±6.8 kg/m²). The mean weight loss 6 months after LSG was 29.1 ±11.1 kg; percentage excess weight loss was 56.2 ±20.4%. Before surgery, 35.5% of patients had constipation and 6.5% of patients had faecal incontinence (FI). No correlation was found between rising level of BMI and constipation or incontinence prevalence/severity. Data analysis has not confirmed increased prevalence/severity of postoperative constipation or incontinence 6 months after LSG. Out of the group of patients with preoperative constipation, clinically relevant improvement was noted in 45.5% of patients after the surgery. Among patients without constipation before surgery, impairment was noted in 21.2% of patients. Out of the group of patients with preoperative incontinence, improvement was found in 37.5% of patients; none of these patients reported clinically relevant impairment of incontinence symptoms.

Conclusions
The present study has not revealed increased prevalence/severity of postoperative constipation or anal incontinence six months after LSG. Our findings suggest that weight loss in patients after LSG might be associated with an improvement of constipation symptoms of individual patients.