Bariatric Surgery in Obesity: Effects on Gut Microbiota and Micronutrient Status

Abstract

Obesity is associated with reduced gut microbial diversity and a high rate of micronutrient deficiency. Bariatric surgery, the therapy of choice for severe obesity, produces sustained weight loss and improvements in obesity-related comorbidities. Also, it significantly alters the gut microbiota (GM) composition and function, which might have an important impact on the micronutrient status as GM is able to synthesize certain vitamins, such as riboflavin, folate, B12, or vitamin K2. However, recent data have reported that GM is not fully restored after bariatric surgery; therefore, manipulation of GM through probiotics represents a promising therapeutic approach in bariatric patients. In this review, we discuss the latest evidence concerning the relationship between obesity, GM and micronutrients, the impact of bariatric surgery on GM in relation with micronutrients equilibrium, and the importance of the probiotics’ supplementation in obese patients submitted to surgical treatment.

Levels of Hydrogen Sulphide or Nitric Oxide in Induced Belching are Indicators of Adequate Gastric Voiding

“…Success of bariatric surgery implies the recovery of gastric microbial diversity [88] and is associated with the recovery of NO production [46,89]. Over use of antibiotic therapy has been associated with obesity [90].…”

Endoscopic bariatric and metabolic therapies for non‐alcoholic fatty liver disease: Evidence and perspectives

“…For this reason, small bowel EBMT may be promising also in the setting of NAFLD in which the metabolic alterations are similar to those that occur in DM2 36 . Whether the effects of intestinal EBMT may be partly related to changes in gut microbiota, as it is observed in Roux‐en‐Y bypass, 37 it is still unknown.…”

Different Weight Loss Intervention Approaches Reveal a Lack of a Common Pattern of Gut Microbiota Changes

“…Several studies have evaluated the relation between gut microbiota changes and the improvement in anthropometric and metabolic variables after bariatric surgery. Animal and human studies have reported common changes after bariatric surgery such as a decrease in the abundance of Firmicutes and an increase in Bacteroidetes, Proteobacteria and its class Gammaproteobacteria (order Enterobacteriales , family Enterobacteriaceae , genus Escherichia ) [ 12 ]. Also, gut microbiota is affected by bariatric surgery in a procedure manner, higher levels of Akkermansia , Eubacterium , Hemophilus and Blautia have been shown in sleeve gastrectomy, whilst in Roux-en-Y gastric bypass Veillonella , Slackia , Granucatiella and Acidaminococcus occurred with greater levels [ 13 ].…”