EP410 - Benign Anorectal Disease Following Bariatric Surgery – Experience from a Single Center from Kuwait. A Retrospective Cohort Study.

Sunday, May 11, 2025

12:46 PM – 12:51 PM PT

Location: Monitor 2, Sails Pavilion, Upper Level

Author(s)

DA

Dalia Albloushi, MBChB

General Surgery Resident
Kuwait Board of General Surgery, KIMS
mishref, Hawalli, Kuwait

Disclosure information not submitted.

ePoster Presenter(s)

Omar A. AlQabandi, MD (he/him/his)

Senior registrar
Jaber Alahmed Hospital
Mubarak Alkabeer, Mubarak al Kabir, Kuwait

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Author(s)

MA

Mohsen Alhashemi, n/a

Assistant Professor
Kuwait University
Kuwait, Hawalli, Kuwait

Disclosure information not submitted.
OA

Omar Alkandari, n/a

Consultant
Kuwait Institute for Medical Specialization, Ministry of Health, Kuwait.
Bayan, Hawalli, Kuwait

Disclosure information not submitted.
HA

Hala Meshal Al-Dabbous, n/a

Medical Student
Kuwait University
Qourtuba, Al Asimah, Kuwait

Disclosure information not submitted.
MJ

Mohammad Jamal, n/a

Professor of Surgery
Kuwait University
Kuwait City, Mubarak al Kabir, Kuwait

Disclosure information not submitted.
AA

Ameera J M S AlHasan, BMBCh, FACS, MRCSEd, KBGS

Senior Specialist General, Colorectal and Pelvic Floor Surgeon
Jaber Al-Ahmad Hospital, Kuwait
Kuwait, Hawalli, Kuwait

Disclosure information not submitted.
sA

salman Alsafran, MD

Assistant professor of surgery
Kuwait university
Abu fatira, Mubarak al Kabir, Kuwait

Disclosure information not submitted.

Senior Author(s)

AA

Ahmed Alkhamis, MD, MSc, FRCSC, FACS, FASCRS

Assistant professor
Kuwait University
Kuwait, Al Asimah, Kuwait

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.

Omar A. AlQabandi, MD: This individual has no financial relationships with ineligible companies.

Ahmed Alkhamis, MD, MSc, FRCSC, FACS, FASCRS: This individual has no financial relationships with ineligible companies.

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Purpose/Background: Bariatric surgery is an effective intervention for the management of morbid obesity, resulting in substantial weight reduction and improvement of obesity-related co-morbidities. Nonetheless, the post-operative period can be associated with a variety of complications, including new onset of benign anorectal disorders (NBRD). Data regarding this are scarce. Our aim is to examine the presence of NBRD post-bariatric surgery and associated risk factors.

Methods/Interventions: This is a retrospective review of 260 patients undergoing bariatric surgery in a single tertiary care center between 2019-2024. Data were collected through medical records and telephone interviews which included demographics, preoperative parameters, co-morbidities, bowel habit and the onset of new anorectal complaints.

Results/Outcomes: Our sample size comprised 260 patients, of whom 61.5% (n=160) were females, with a mean age of 34.5 ± 11.9 years. The mean preoperative BMI is 40.1 ± 7.5. A total of 65.0% (n=169), underwent laparoscopic sleeve gastrectomy while 26 patients (10%) underwent gastric bypass. Postoperatively, NBRD was observed in 9.6% (n=25) of the cohort, with 10.4% (n=27) experiencing constipation and 1.5% (n=4) reporting diarrhea. Medical intervention was required for 61.9% (n=16) of the patients experiencing anorectal complications, whereas surgical intervention was needed in only one patient, 3.9%. Multivariate analysis demonstrated that there is a 3% increase in the odds of bowel habit changes for every one-year increase in age (OR 1.03, 95% CI 1.003-1.07). Additionally, diabetes mellitus (DM) was found to be associated with an 82% decrease in the odds of change in bowel habit (OR 0.18, 95% CI 0.04-0.87). Furthermore, we found that the odds of anorectal disease is ~ 11 times greater in those whom developed bowel habit changes (OR 10.9, 95% CI 4.2-28.3)

Conclusion/Discussion: This study emphasizes on significant findings concerning the new onset of benign anorectal disorders post-bariatric surgery. Such complication can be observed in 9.6% highlighting a remarkable concern, especially given the positive and successful results in achieving weight reduction, despite the scarce available data. It appears that being diabetic and young are protective of having significant change in bowel habit post bariatric surgery. Furthermore, changes in bowel habit after bariatric surgery is the most important predictor of anorectal complications. To conclude, the associated risk of developing benign anorectal disease necessitates the development of follow-up protocols and tailored dietary strategies aimed to minimize altered bowel habits.