Nutrition Department (Nassif Clinic), Santa Casa de Misericórdia de Curitiba Hospital, Rua Bruno Filgueira, 485 - Batel, 80240-220,, Curitiba, Paraná, Brazil.
Clinical Surgery Department, Federal University of Parana, Curitiba, Brazil.
Obes Surg. 2021 Jan;31(1):143-150. doi: 10.1007/s11695-020-04900-x. Epub 2020 Aug 11.
Bariatric surgery may cause undesirable gastrointestinal symptoms due to anatomical, functional and intestinal microbiota changes.
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).
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.
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.
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.
减重手术可能会由于解剖、功能和肠道微生物群的改变而引起不良的胃肠道症状。
本研究旨在评估益生菌补充对 Roux-en-Y 胃旁路术（RYGB）后患者胃肠道症状和小肠细菌过度生长（SIBO）的影响。
这是一项前瞻性、随机、双盲、安慰剂对照试验。患者被随机分为对照组（CG）（n=39）和益生菌组（PG）（n=34）。PG 组服用含有嗜酸乳杆菌和双歧杆菌（50 亿 CFU/株）的片剂 90 天，CG 组服用淀粉片。在手术前（T0）和手术后 45 天（T1）和 90 天（T2），两组均回答胃症状评分量表（GSRS）问卷和 3 天食物记录。在 T0 和 T2 时，使用氢呼气试验来验证 SIBO 的存在。
SIBO 的患病率在各时间点相似，GSRS 反应的平均评分在任何时间点两组之间均无差异。然而，PG 组患者报告的腹胀少于 CG 组，T1 时腹痛更多（T2 时减少），T1 时软便和恶心发作更多，术后饥饿痛减少，但没有紧急排便发作的报告，尽管他们比 CG 组摄入了更多的脂肪。
嗜酸乳杆菌和双歧杆菌的补充可有效减轻腹胀，但对术后早期 SIBO 的发展没有影响。
