Probiotics, Bariatric Surgery and Poorly Studied Consequences

In a class involving the subjects "bariatric surgery" and "eating disorders" I rose a doubt about the configuration of the intestinal flora after all the cut-pull-squeeze-stitching of this kind of surgery.

Probiotics are microorganisms that have always instigated me. In the BA and in the specialization I have researched about them, and every now and then I keep reading more scientific articles that cross this theme with many others: application in the ICU, weight maintenance, inflammatory diseases, metabolic syndrome, immune system, etc.

Probiotics are defined by FAO and WHO (2002) as "living organisms which, when administered in adequate quantities, confer a beneficial effect on host health"

It is known that the composition of our flora is highly influenced by our diet - especially in our first years of life. Above all, it is understood that a varied diet, rich in fresh and minimally processed foods, allows the maintenance of an organized and balanced flora.

Recently, dozens of evidences have proposed that, besides the many factors that influence the development of metabolic diseases, a "malnourished" microbiota adds up as a pathogenic factor.

Not only, but a cascade of losses is triggered by this malnutrition, such as:

• Deficient nutrient absorption (due to epithelial alteration and unproductive fermentation in the gastrointestinal tract)

• Low intestinal motility

• Poor protection against pathogens and consequent impaired immune system

• Appetite alteration

• Change in glucose and lipids metabolism, and its storage in the liver

It is established, by the same line of research, that an adequate supplementation of probiotics promote beneficial effects in the metabolic syndrome, weight loss, reduction of visceral adiposity, improvement of glucose tolerance, reduction of inflammatory processes, improvement of epithelial barrier and reduction of bacterial translocation.

What about bariatric surgery?

Depending on the used technique (and in addition to the super low food intake that occurs at the postoperative and the stress of the period) the growth and composition of the intestinal flora is affected. Consequently, nausea, flatulence, diarrhea, abdominal pain, bacterial translocation and even the development of metabolic endotoxemia can occur.

It is already understood that antibiotic therapy is a shot in the foot, so a safe solution that begins to be studied is the prescription for probiotics.

Its administration is generally safe, including low data on side effects. However, all care is little. It is always reccomended that a proper prescription must be done and followed by a professional expert in the subject!

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FESTI, Davide et al. Gut microbiota and metabolic syndrome. World Journal Of Gastroenterology, [s.l.], v. 20, n. 43, p.16079-16094, nov. 2014. Baishideng Publishing Group Inc.. http://dx.doi.org/10.3748/wjg.v20.i43.16079.

JEPPSSON, Bengt; MANGELL, Peter; THORLACIUS, Henrik. Use of Probiotics as Prophylaxis for Postoperative Infections. Nutrients, [s.l.], v. 3, n. 12, p.604-612, 12 maio 2011. MDPI AG. http://dx.doi.org/10.3390/nu3050604.

FAO. Probiotics. 2002. Disponível em: <http://www.fao.org/food/food-safety-quality/a-z-index/probiotics/en/>. Acesso em: 03 jul. 2017.