Rethinking post-bariatric care: anorectal morbidity following sleeve gastrectomy and roux-en-Y gastric bypass

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dc.contributor.authorErdem, Olgun
dc.contributor.authorAcar, Aylin
dc.contributor.authorCanbak, Tolga
dc.contributor.authorBaşak, Fatih
dc.contributor.authorKudaş, İlyas
dc.contributor.authorTosun, Hüsna
dc.contributor.authorTekesin, Kemal
dc.contributor.authorŞişik, Abdullah
dc.date.accessioned2026-04-16T07:35:43Z
dc.date.available2026-04-16T07:35:43Z
dc.date.issued2026
dc.departmentFakülteler, Sağlık Bilimleri Fakültesi
dc.description.abstractBACKGROUND: Bariatric surgery is a prevalent and effective treatment for morbid obesity, yet its potential long-term effects on anorectal health remain an under-investigated aspect of post-operative care. This study aimed to meticulously evaluate the incidence and the degree of severity of two common anorectal conditions, anal fissures and hemorrhoids, in a substantial cohort of patients following either sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB), two frequently performed bariatric procedures. Understanding these potential post-surgical morbidities is crucial for a comprehensive approach to patient management. METHODS: A retrospective cohort study at a large tertiary referral center (2015-2023) included 280 patients (200 SG, 80 RYGB). Detailed pre- and post-operative data on anorectal conditions, bowel habits, and surgical outcomes were extracted from electronic records and statistically analyzed. RESULTS: The overall incidence of new-onset anorectal disorders (defined as the development of at least one of the conditions) was significantly higher in the RYGB group (47.5%) compared to the SG group (32.5%) ( P <0.001). Specifically, the incidence of new-onset hemorrhoids (36.5% vs. 23.5%, P =0.02) and anal fissures (29.0% vs. 16.0%, P =0.01) occurred more frequently in the RYGB group. The mean severity scores were also higher (Goligher score: 2.6±0.8 vs. 2.1±0.7, P = 0.01; fissure severity: 2.9±1.0 vs. 2.3±0.9, P = 0.02). Post-operative constipation and diarrhea were associated with higher risk, and RYGB was an independent predictor. Multivariate analysis, adjusting for age, sex, and baseline BMI, confirmed RYGB (OR 1.7, 95% CI 1.1-2.5, P =0.01) and post-operative constipation (OR 2.0, 95% CI 1.3-3.0, P =0.001) as independent predictors of new-onset anorectal disorders. CONCLUSIONS: Our findings highlight that not all bariatric procedures carry the same risk for anorectal complications, and RYGB specifically warrants closer attention. These findings underscore the clinical importance of incorporating proactive assessment and management of anorectal health, including bowel habit regulation and symptom monitoring, into the routine post-operative care of bariatric surgery patients to optimize their overall well-being.
dc.identifier.doi10.1097/SLE.0000000000001435
dc.identifier.issn1530-4515
dc.identifier.issn1534-4908
dc.identifier.issue2
dc.identifier.pmid41556413
dc.identifier.scopus2-s2.0-105034979643
dc.identifier.scopusqualityQ2
dc.identifier.urihttps://doi.org/10.1097/SLE.0000000000001435
dc.identifier.urihttps://hdl.handle.net/11501/2684
dc.identifier.volume36
dc.identifier.wosWOS:001732614800010
dc.identifier.wosqualityQ3
dc.indekslendigikaynakPubMed
dc.indekslendigikaynakScopus
dc.indekslendigikaynakWeb of Science
dc.institutionauthorŞişik, Abdullah
dc.language.isoen
dc.publisherLippincott Williams and Wilkins
dc.relation.ispartofSurgical Laparoscopy, Endoscopy & Percutaneous Techniques
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectAnal Fissure
dc.subjectAnorectal Disorders
dc.subjectBariatric Surgery
dc.subjectHemorrhoids
dc.subjectRoux-En-Y Gastric Bypass
dc.subjectSleeve Gastrectomy
dc.titleRethinking post-bariatric care: anorectal morbidity following sleeve gastrectomy and roux-en-Y gastric bypass
dc.typeArticle

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