Differential Impact of Laparoscopic Sleeve Gastrectomy and Roux-en-Y Gastric Bypass on Postoperative Constipation: Insights for Optimized Patient Care

Abstract

Background:

While bariatric surgery effectively treats morbid obesity, its impact on postoperative bowel habits, particularly constipation, remains underexplored. This study compared constipation prevalence and changes after laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (RYGB).

Methods:

A prospective observational study included 120 patients undergoing LSG or RYGB, evaluated preoperatively and 6 months postoperatively. Constipation was assessed using bowel habit parameters and the Wexner Constipation Score (WCS). Incontinence was assessed using the Cleveland Clinic Incontinence Score (CCIS).

Results:

Preoperative constipation prevalence was similar between groups. At 6 months, trends toward improvements in WCS (LSG: 4.9 to 4.3; RYGB: 5.1 to 4.8) and CCIS (LSG: 8.5 to 8.1; RYGB: 8.7 to 8.4) were observed, with more patients reporting better bowel habits. WCS and CCIS scores decreased in both groups at 6 months compared with baseline, but these changes were not statistically significant.

Conclusion:

No significant differences in postoperative constipation outcomes (WCS) were observed between RYGB and LSG patients, although both showed a trend toward improved bowel habits. Similarly, CCIS changes were not significantly different. These findings suggest potential benefits for bowel function, but further research is needed to determine their clinical importance and underlying causes.