Nathalia Ramori Farinha Wagner1,2, Marilia Rizzon Zaparolli Ramos3,4, Ligia de Oliveira Carlos3, Magda Rosa Ramos da Cruz5, Cesar Augusto Taconeli6,7, Alcides José Branco Filho8, Luis Sergio Nassif8, Maria Eliana Madalozzo Schieferdecker9, Antônio Carlos Ligocki Campos3. 1. Nutrition Department (Nassif Clinic), Santa Casa de Misericórdia de Curitiba Hospital, Rua Bruno Filgueira, 485 - Batel, 80240-220,, Curitiba, Paraná, Brazil. nathalia_farinha@yahoo.con.br. 2. Clinical Surgery Department, Federal University of Parana, Curitiba, Brazil. nathalia_farinha@yahoo.con.br. 3. Clinical Surgery Department, Federal University of Parana, Curitiba, Brazil. 4. Positivo University, Curitiba, Brazil. 5. Pontifical Catholic University of Paraná (PUCPR), Curitiba, Brazil. 6. Department of Statistics, Federal University of Paraná, Curitiba, Brazil. 7. ESALQ-USP, Curitiba, Brazil. 8. Santa Casa de Misericórdia de Curitiba Hospital, Curitiba, Brazil. 9. Nutrition Department, Federal University of Parana, Curitiba, Brazil.
Abstract
Bariatric surgery may cause undesirable gastrointestinal symptoms due to anatomical, functional and intestinal microbiota changes. PURPOSE: The aim of this study was to evaluate the effect of probiotic supplementation on gastrointestinal symptoms and small intestine bacterial overgrowth (SIBO) in patients after Roux-en-Y gastric bypass (RYGB). MATERIALS AND METHODS: This is a prospective, randomized, double-blind, placebo-controlled trial. The patients were randomized into Control Group (CG) (n = 39) and Probiotic Group (PG) (n = 34). The PG received tablets containing Lactobacillus acidophilus and Bifidobaterium lactis (5 billion CFU/strain) for 90 days, and the CG received tablets with starch. Both the Gastric Symptom Rating Scale (GSRS) questionnaire and 3-day food record were answered before surgery (T0) and after 45 days (T1) and 90 days of surgery (T2). At T0 and T2, hydrogen breath test was used to verify the presence of SIBO. RESULTS: The prevalence of SIBO was similar among times, and the mean score of GSRS responses did not differ between groups at any time. However, PG patients reported less bloating compared to CG, more abdominal pain at T1 (which reduced at T2), more episodes of soft stools and nausea and less hunger pain after surgery, with no reports of urgent episodes to evacuate, even though they consumed more fat than the CG. CONCLUSIONS: The supplementation of L. acidophilus and B. lactis is effective in reducing bloating, but without influencing the development of SIBO in the early postoperative period.
RCT Entities:
Bariatric surgery may cause undesirable gastrointestinal symptoms due to anatomical, functional and intestinal microbiota changes. PURPOSE: The aim of this study was to evaluate the effect of probiotic supplementation on gastrointestinal symptoms and small intestine bacterial overgrowth (SIBO) in patients after Roux-en-Y gastric bypass (RYGB). MATERIALS AND METHODS: This is a prospective, randomized, double-blind, placebo-controlled trial. The patients were randomized into Control Group (CG) (n = 39) and Probiotic Group (PG) (n = 34). The PG received tablets containing Lactobacillus acidophilus and Bifidobaterium lactis (5 billion CFU/strain) for 90 days, and the CG received tablets with starch. Both the Gastric Symptom Rating Scale (GSRS) questionnaire and 3-day food record were answered before surgery (T0) and after 45 days (T1) and 90 days of surgery (T2). At T0 and T2, hydrogen breath test was used to verify the presence of SIBO. RESULTS: The prevalence of SIBO was similar among times, and the mean score of GSRS responses did not differ between groups at any time. However, PGpatients reported less bloating compared to CG, more abdominal pain at T1 (which reduced at T2), more episodes of soft stools and nausea and less hunger pain after surgery, with no reports of urgent episodes to evacuate, even though they consumed more fat than the CG. CONCLUSIONS: The supplementation of L. acidophilus and B. lactis is effective in reducing bloating, but without influencing the development of SIBO in the early postoperative period.
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Authors: Ligia de Oliveira Carlos; Marilia Rizzon Zaparolli Ramos; Nathalia Ramori Farinha Wagner; Lineu Alberto Cavazani de Freitas; Ingrid Felicidade; Antonio Carlos Ligocki Campos Journal: Arq Bras Cir Dig Date: 2022-06-24