Evolution of Perianal Pathology in Patients Undergoing Bariatric Surgery. A Prospective, Multicentre Study With 12-month Follow-up.

Abstract Introduction: Bariatric surgery provides good weight-loss results over the medium to long term, improving a significant number of comorbidities. Benign anal pathology is common; in addition, obesity is part of the pathophysiology of some of these diseases. Objectives: The aim of this study is to describe and analyse benign anal pathology in patients affected by obesity who are candidates for bariatric surgery, as well as to assess its evolution after 12 months following weight-loss surgery. Methodology: A descriptive, prospective, multicentre study was designed. Seventy patients who were candidates for bariatric surgery were included. At first contact, initial descriptive variables (weight, BMI, etc.) were collected, a perianal examination was performed, and quality-of-life questionnaires (SF12v2, HEMO-FISS-QoL) were completed. The second contact took place 12 months after surgery, in which the variables and questionnaires were again recorded. Results: At 12 months from the intervention, a significant decrease in both the prevalence of symptomatic internal haemorrhoids and external haemorrhoids (p<0.001) was observed. The mean number of acute hidradenitis suppurativa flare-ups decreased significantly, to 0.22 over the preceding 6 months (p<0.001). Quality of life improved significantly, both generally and in relation to perianal pathology. Conclusion: Patients who underwent bariatric surgery using restrictive and hypoabsorptive techniques showed an improvement in their perianal pathology, as well as a significant improvement in their quality of life. To consolidate these results more studies are required that encompass a larger number of patients and a longer evolution period.