Benign Anorectal Disease Following Weight Loss Interventions Including Bariatric Surgery: A Retrospective Cohort Study.

BACKGROUND: Bariatric and metabolic surgery (MBS) and intra-gastric balloons (IGBs) are effective interventions for the treatment of obesity, resulting in substantial weight reduction and improvement in associated comorbidities. Nonetheless, the postoperative period can be complicated by new onset of benign anorectal disorders (NBADs). This study aims to examine the incidence and risk factors associated with NBADs following these weight loss interventions. METHODS: We conducted a retrospective review of patients who underwent MBS and IGBs in a si ngle center between 2019 and 2024. Data were collected through electronic medical records and follow-up telephone interviews, assessing demographics, comorbidities, bowel habit changes and anorectal symptoms. RESULTS: A total of 371 patients were included, with a mean age of 34.7 ± 11.6 years; 62.3% were female. Laparoscopic sleeve gastrectomy was the most common intervention (64.7%), followed by malabsorptive procedures (9.1%). The rate of NBADs was 10.78% (n=40). Multivariate analysis identified age (OR 1.03, 95% CI: 1.001-1.06, p<0.05) and diabetes mellitus (OR: 4.1, 95% CI: 1.2-14.2, p<0.05) as independent risk factors for developing post operative changes in bowel habits. Importantly, constipation demonstrated the strongest association with NBADs (OR 10.4 CI: 4.7-23.1, p<0.001). CONCLUSION: NBADs occur in over 10% of patients following weight loss interventions with constipation being the strongest predictor. These findings highlight the need for proactive monitoring and personalized dietary strategies to manage bowel habit changes and reduce the risk of anorectal complications.