Changes in Symptoms and General Well-being After Reversal of Roux-en-Y Gastric Bypass: A Questionnaire Survey

Abstract

Abstract Purpose After Roux-en-Y gastric bypass (RYGB), few patients develop severe complications, which ultimately may require reversal of RYGB. We aimed to examine the effect of reversal of RYGB on symptoms and well-being. Materials and Methods Via contact to medical and surgical departments treating patients with RYGB, we identified 18 patients, who had undergone reversal, 2009–2019. We conducted a Danish, nationwide questionnaire survey concerning symptoms before and after reversal of the RYGB including the patients’ own perceptions of their well-being. Results Fourteen patients responded to the questionnaire (86% female; median age at RYGB, 36.2 years [IQR, 30.9–38.6 years]). The median time from RYGB to reversal was 5.8 years (IQR, 5.1–7.5 years). After RYGB, 13 patients (93%) reported abdominal pain, while 12 patients still had abdominal pain after reversal. Six out of 11 patients (45%) reported complete remission of dumping/post-bariatric hypoglycemia (PBH) after reversal. Malabsorption disappeared in 10 out of 11 patients (90%). Reversal had minor effect on neuropathy. The median weight loss from RYGB was 61 kg (IQR, 56–75 kg), while the median weight regain after reversal was 30 kg (IQR, 13–46 kg). Regarding the well-being, 72 of the patients felt better or much better after reversal. Conclusion In total, 72% of the patients felt better or much better after reversal of RYGB, though some still had RYGB-related symptoms. The reversal relieved dumping/PBH and malabsorption, but not abdominal pain and neuropathy. Finally, half of the weight loss was regained after reversal. Reversal of RYGB may be an option in highly selected cases. Graphical Abstract