Postcholecystectomy Postcholecystectomy Bowel Motion Changes and Diarrhea A Prospective Study ,Hasanain Abdulameer Jasim* CABS FICMS

Abstract

ABSTRACT

Background: Cholecystectomy is one of the most commonly performed surgery in surgical practice. It's clearly affect bowel motion regarding frequency and consistency. Postcholecystectomy diarrhea is considered the most common non-pain squuelae after surgery, despite that still the pathophysiology of condition is not fully understood. It is thought to be related to bile acid malabsorption and change of colonic transit time, in addition the associated risk factors, prevalence of the condition still not well defined.

Objectives: To evaluate change of bowel motion in patients with cholecystectomy, to define prevalence of postcholecystectomy diarrhea, nature, etiology and possible risk factors of postcholecystectomy diarrhea.

Methods: One hundred and fourteen patients included in the study who undergo cholecystectomy, all patients interviewed preoperatively and then after surgery at period 2 weeks, 3 months and 6 months after surgery all demographic data was collected and special consideration regarding bowel motion frequency and consistency was taken and according to Bristol diarrhea scale, WHO definition of diarrhea. We classified bowel motion consistency into (hard, well-formed, loose, watery) and identified patients with diarrhea, similarly patients with constipation is also identified.

Results: Forty-four patients (38.59%) developed postcholecystectomy diarrhea during period of study. Thirty-four (77.27%) were females and (10) (22.73%) were males. The mean number of bowel motion frequency per day increased from 1.1 before surgery to 1.9 in period between 2 weeks and 3 months after surgery, stool consistency form was also changed that hard bowel motion decrease from 35.1% before surgery to 8.8% in period between 2 weeks and 3 months and loose bowel motion from17.5% to 29.8% within 2 weeks after surgery.

Conclusion: Cholecystectomy show marked change in bowel habit in post cholecystectomy period. The postcholecystectomy diarrhea is common problem in postcholecystectomy period. The high BMI especially obesity grade C2, 3 and younger age group less than 40 years showed significant association with development of postcholecystectomy diarrhea, but the sex of the patient and type of surgery (laparoscopic and open surgery) show no significant association with development of postcholecystectomy diarrhea. Patients with cholecystectomy showed increase mean bowel frequency per day and change of bowel motion consistency from hard toward lose and watery bowel motion after cholecystectomy.