Abstract
ABSTRACTIntroduction: Studies suggest that weight loss induced by bariatric surgery and the remission of some comorbidities may be related to changes in the microbiota profile of individuals undergoing this procedure. In addition, there is evidence that manipulation of the intestinal microbiota may prove to be a therapeutic approach against obesity and metabolic diseases. Objective: To verify the changes that occur in the intestinal microbiota of patients undergoing bariatric surgery, and the impact of the usage of probiotics in this population. Methods: Articles published between 2007 and 2017 were searched in Medline, Lilacs and Pubmed with the headings: bariatric surgery, microbiota, microbiome and probiotics, in Portuguese, English and Spanish. Of the 166 articles found, only those studies in adults subjected to either Roux-en-Y gastric bypass or sleeve vertical gastrectomy published in original articles were enrolled. In the end, five studies on the change of intestinal microbiota composition, four on the indirect effects of those changes and three on the probiotics administration on this population were enrolled and characterized. Conclusion: Bariatric surgery provides changes in intestinal microbiota, with a relative increase of the Bacteroidetes and Proteobacteria phyla and reduction of Firmicutes. This is possibly due to changes in the gastro-intestinal flux, coupled with a reduction in acidity, in addition to changes in eating habits. The usage of probiotics seems to reduce the gastro-intestinal symptoms in the post-surgery, favor the increase of vitamin B12 synthesis, as well as potentiate weight loss.
Highlights
Obesity is defined as an abnormal accumulation or an excess of body fat, which may reach a health-impairing degree
After the association of terms and exclusion of repeated papers in each database search, 33 articles were found in Medline; 166 in Pubmed and no paper was found by the search in Lilacs database
The guiding questions of this study were: “What are the changes in intestinal microbiota of individuals submitted to bariatric surgery?” and “What are the effects of probiotics in health and life quality of the patients following bariatric surgery?”
Summary
Obesity is defined as an abnormal accumulation or an excess of body fat, which may reach a health-impairing degree. Its etiology is multifactorial and complex, resulting from an interaction of genes, environment, lifestyle and emotional factors[5]. Bariatric surgery is the treatment with the most consistent results in excess weight loss, remission of comorbidities and improving life quality[1]. The first consists of a technique that couples the reduction of gastric volume and a detour of the proximal intestine, while the latter is a restrictive technique in which 80% of the greater curvature of the stomach is ressected[1]. During the last couple decades, a lot has been learned on the physiological mechanisms, as well as the neuro-hormonal circuits and their functions in the control of the body composition, of the genes and of the mechanisms that determine the susceptibility to obesity[9,12]. Intestinal dysbiosis has been considered an additional factor for the development of obesity and type II diabetes melittus[15,27]
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