According to recent research, more knowledge of social, physical, and psychological factors affecting patients being considered for weight-loss surgery is needed. This may facilitate the identification of those at risk of stomach pain and long-term use of opioids after surgery.
By Amalie H. Simoni
Weight-loss surgery is widely used as a treatment for severe obesity. However, little is known about the long-term consequences, which include stomach pain and thus opioid use as painkiller. A recent literature study, published in the Scandinavian Journal of Pain, aimed to identify data from existing studies on chronic stomach pain and long-term opioid use after weight-loss surgery, as well as the possible consequences associated with this.
The search revealed that chronic stomach pain and opioid use were frequent after weight-loss surgery. Stomach pain was the most presented problem after weight-loss surgery in those who were in contact with the health care system within five years after surgery. This could be explained by changes in eating behaviours, or structural or functional modifications of the stomach.
Additionally, the search revealed that long-term opioid use increased after weight-loss surgery, and 4-14% of patients started long-term opioid use after surgery. Changes in drug absorption after weight-loss surgery may change the effects of the drugs and increase the risk of side effects and addiction. No identified studies found changes in absorption caused only by surgical changes, since extreme weight-loss may itself cause changes. Subjects with long-term opioid use after weight-loss surgery experienced less weight-loss and benefits from the surgery. Thus, remission from type II diabetes and heart disease may be limited in these patients.
Knowledge of the effects of individual weight-loss procedures on pain and long-term opioid use are unclear. However, in general, more attention to physical and psychological factors may facilitate better identification of those at risk of stomach pain and long-term opioid use and improve treatment recommendations for these patients.
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