Metabolic and Bariatric Surgery

Biography

Biography: Sukaina Jaffar

Abstract

Background: Few studies have reported the prevalence of dysphagia, as its own clinical entity in the bariatric population; without being examined under the umbrella of gastro-oesophageal reflux disease. This is compounded by studies not outlining methodologies used to assess dysphagia. Moreover, varying follow-up periods and different bariatric procedures have led to conflicting results.

Objectives: To assess the prevalence of dysphagia using a statistically robust patient-reported tool, Dysphagia Handicap Index (DHI) post Laparoscopic Sleeve Gastrectomy (LSG). DHI is a validated tool which additionally measures the handicapping effects of dysphagia on emotional and functional domains of living. Methods: DHI questionnaire was administered to 124 patients who underwent LSG at least 1 year prior. Post-operative weight, change in BMI, percent Total Weight Loss (%TWL) and percent Excess Weight Loss (%EWL) were calculated. Physical, emotional and functional subscales were analyzed separately and altogether. Three additional questions were added to the DHI to delineate oesophageal dysphagia.

Results: Average pre-operative weight and BMI is 123.8 kg and 43 kg/m2, respectively. Median %TWL and %EWL are 32% and 76.2%, respectively. An average reduction in BMI value of 14 kg/m2 was found. 41% of our cohort reported to mild dysphagia and 54% reported moderate to severe dysphagia based on the Modified DHI Score (DHI+Oesophageal Specific Dysphagia Score). No patient required corrective intervention. Patients reporting higher DHI scores were less likely to achieve the median TWL of 35.4 kg (OR 0.40, 95% CI 0.17-0.91). Dysphagia is a common symptom reported in our cohort and was found to have an impact on weight loss outcomes.

Conclusion: Prospective, single-institution analysis using a validated tool reveals post-operative dysphagia to be a common clinical entity in our population with functional and psychological influences.