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Background: Chronic abdominal pain (CAP) after bariatric surgery is not extensively explored and may impact the postoperative outcomes., Objective: To compare the prevalence of patient-reported chronic abdominal pain (CAP) after Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). Secondarily, we compared other abdominal and psychological symptoms and quality of life (QoL). Preoperative predictors of postoperative CAP were also explored., Setting: Tertiary referral centers for bariatric surgery in Norway., Methods: Analyses of 2 separate prospective longitudinal cohort studies evaluating CAP, abdominal and psychological symptoms and QoL before and 2 years after RYGB and SG., Results: Follow-ups were attended by 416 patients (85.8%), 300/416 (72.1%) were females and 209/416 (50.2%) were RYGB procedures. At follow-up, the mean age was 44.9 (10.0) years, BMI 29.5 (5.4) kg/m 2 , and total weight loss 31.6 (10.3) %. The prevalence of CAP was 28/236 (11.9%) before and 60/209 (28.7%) after RYGB (P < .001) and 32/223 (14.3%) before and 50/186 (26.9%) after SG (P < .001). Gastrointestinal symptom rating scale scores showed greater deterioration of diarrhea and indigestion after RYGB and reflux after SG. The improvement in depression symptoms was greater after SG, as well as several QoL scores improved more after SG. Patients with CAP after RYGB experienced deterioration in several QoL scores, while these scores improved in patients with CAP after SG. Preoperative hypertension, bothersome reflux symptoms, and CAP predicted postoperative CAP., Conclusions: The prevalence of CAP increased comparably after RYGB and SG, with worsening of gastroesophageal reflux after SG and greater deterioration of diarrhea and indigestion after RYGB. In patients with CAP at follow-up, several QoL scores improved more after SG than RYGB., (Copyright © 2023 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)

Background: Sleeve gastrectomy (SG) is widely applied. Few studies have evaluated patient-reported abdominal symptoms after SG., Objective: To evaluate the prevalence of chronic abdominal pain (CAP) and symptom characteristics after SG., Setting: Oslo University Hospital and Voss Hospital., Methods: We performed a longitudinal prospective cohort study of patients operated on with SG at two tertiary referral centers. For broad assessments of abdominal pain and symptoms, consultations were performed and questionnaires retrieved before and 2 years after SG. The definition of CAP or recurrent abdominal pain lasting for more than 3 months was sustained. Preoperative predictors of CAP were explored., Results: Of 249 patients at baseline, 207 (83.1%) had follow-up consultations. Mean preoperative body mass index was 43.9 (6.0) kg/m 2 , and 181 patients (72.7%) were female. Total weight loss was 31.9% (10.4%). CAP was reported in 32 of 223 patients (14.3%) before and in 50 of 186 patients (26.9%) after SG (P =.002). All mean gastrointestinal symptoms rating scale questionnaire scores increased after SG, and they were higher in patients with CAP. Symptoms of depression decreased but were more prevalent in patients with CAP at follow-up. Most quality-of-life scores increased after SG. However, patients with CAP had lower scores (except for physical functioning). Preoperative bothersome Gastrointestinal Symptom Rating Scale reflux symptoms, study center, and younger age seemed to predict CAP after SG., Conclusion: The prevalence of patient-reported CAP increased after SG. Patients reporting CAP had reduced quality-of-life scores., (Copyright © 2021 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)

Background: Knowledge of optimal diagnostic workup, etiology, and response to treatment of chronic abdominal pain after Roux-en-Y gastric bypass (RYGB) is limited., Objective: To define the etiology of chronic abdominal pain presenting at the 5-year follow-up after RYGB and to evaluate response to treatment., Setting: Oslo University Hospital (tertiary referral center for obesity surgery)., Methods: Of 234 patients operated during a randomly selected 12-month period, 165 (71%) returned for 5-year follow-up, and 160 responded to study questionnaires. Of these, 54 (34%) reported chronic abdominal pain and were invited to participate in a structured diagnostic and treatment algorithm. These patients were contacted for the evaluation of their response to treatment., Results: Fifty-one of 54 patients (94%) reporting chronic abdominal pain at the 5-year follow-up were included in the study. Of the 45 patients with onset of symptoms post-RYGB, 28 (62%) underwent one or more radiologic evaluations, 10 (22%) underwent endoscopy, and 13 (29%) underwent laparoscopy. Diagnosis and treatment were established for 34 patients (76%), whereas 11 (24%) had abdominal pain of unknown cause. The most common etiology was internal herniation (n = 6), dumping (n = 6), food intolerance (n = 6), gallstones (n = 5), and irritable bowel syndrome (n = 4). After a median follow-up of 13.0 months (standard deviation, 11.5), 37 (82%) patients reported remission or improvement of symptoms, 6 had unchanged symptoms, and 2 patients were lost to follow-up., Conclusions: The etiology of long-term chronic abdominal pain post-RYGB is diverse. A multidisciplinary team can help most patients with dedicated follow-up, but a subset of patients has symptoms of unknown etiology., (Copyright © 2018. Published by Elsevier Inc.)

Background: Bile acids have been proposed as key mediators of the metabolic effects after bariatric surgery. Currently no reports on bile acid profiles after duodenal switch exist, and long-term data after gastric bypass are lacking., Objective: To investigate bile acid profiles up to 5 years after Roux-en-Y gastric bypass and biliopancreatic diversion with duodenal switch and to explore the relationship among bile acids and weight loss, lipid profile, and glucose metabolism., Settings: Two Scandinavian University Hospitals., Methods: We present data from a randomized clinical trial of 60 patients with body mass index 50-60 kg/m 2 operated with gastric bypass or duodenal switch. Repeated measurements of total and individual bile acids from fasting serum during 5 years after surgery were performed., Results: Mean concentrations of total bile acids increased from 2.3 µmol/L (95% confidence interval [CI], -.1 to 4.7) at baseline to 5.9 µmol/L (3.5-8.3) 5 years after gastric bypass and from 1.0 µmol/L (95% CI, -1.4 to 3.5) to 9.5 µmol/L (95% CI, 7.1-11.9) after duodenal switch; mean between-group difference was -4.8 µmol/L (95% CI, -9.3 to -.3), P = .036. Mean concentrations of primary bile acids increased more after duodenal switch, whereas secondary bile acids increased proportionally across the groups. Higher levels of total bile acids at 5 years were associated with lower body mass index, greater weight loss, and lower total cholesterol., Conclusions: Total bile acid concentrations increased substantially over 5 years after both gastric bypass and duodenal switch, with greater increases in total and primary bile acids after duodenal switch. (Surg Obes Relat Dis 2017;0:000-000.) © 2017 American Society for Metabolic and Bariatric Surgery. All rights reserved., (Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)

Background: Few long-term reports with high rates of follow-up are available after gastric bypass. We report changes in weight, co-morbidity, cardiovascular risk, and health-related quality of life (HRQoL) 5 years after gastric bypass., Methods: Patients who had gastric bypass (2004-2006) were included. Prospective data were reviewed. Long-term complications, cardiovascular risk factors, and HRQoL were evaluated, and the 10-year risk for coronary heart disease was estimated (Framingham risk score). Outcomes were compared in patients with body mass index (BMI)<50 and ≥50 kg/m(2)., Results: A total of 184 of 203 patients (91%) met to follow-up. The mean ± SD preoperative BMI was 46 ± 5 kg/m(2), and the mean ± SD age was 38 ± 9 years; 75% were women. Thirty-two percent of the patients had a BMI ≥50 kg/m(2), and 30% had type 2 diabetes. Follow-up was 63 ± 5 months. After 5 years, total weight loss was 27% ± 11%. Remission of type 2 diabetes had occurred in 67%. The prevalence of hypertension, dyslipidemia, sleep apnea, and metabolic syndrome had decreased. HRQoL was improved. The Framingham risk score was reduced (5.6% versus 4.6%; P = .021). Sixty-one patients (33%) had long-term complications, most commonly chronic abdominal pain (10%). BMI was 33 ± 5 and 37 ± 7 kg/m(2) in patients with preoperative BMI<50 and ≥50 kg/m(2), but changes in metabolic, cardiovascular risk profile and HRQoL were broadly similar., Conclusions: Beneficial effects on weight loss, cardiovascular risk, and HRQoL were documented 5 years after gastric bypass in morbidly and super-obese patients., (Copyright © 2014 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)