Probiotics administration following sleeve gastrectomy surgery: a randomized double-blind trial

Area of Science:

• Bariatric Surgery Outcomes
• Gastroenterology
• Microbiome Research

Background:

• Probiotics are frequently recommended post-bariatric surgery, but their effectiveness remains unclear.
• Laparoscopic sleeve gastrectomy (LSG) is a common bariatric procedure.
• Nonalcoholic fatty liver disease (NAFLD) is a prevalent comorbidity in patients undergoing LSG.

Purpose of the Study:

• To compare the efficacy of probiotics versus placebo in improving hepatic, inflammatory, and clinical outcomes after LSG.
• To assess the impact of probiotics on liver fat content, fibrosis, and metabolic parameters.
• To evaluate changes in microbiota composition following LSG and probiotic supplementation.

Main Methods:

• A randomized, double-blind, placebo-controlled trial involving 100 patients with NAFLD undergoing LSG.
• Participants received either probiotics (Bio-25) or placebo for 6 months, with an additional 6 months of follow-up.
• Outcomes included liver fat reduction (ultrasound), fibrosis assessment (shear-wave elastography), metabolic and inflammatory markers, anthropometrics, quality of life, and fecal microbial analysis.

Main Results:

• No significant differences were observed between probiotic and placebo groups in liver fat content or NAFLD remission rates at 6 and 12 months post-LSG.
• While fibrosis, liver enzymes, C-reactive protein, leptin, and cytokeratin-18 levels decreased, and quality of life improved within both groups, these changes were not significantly different between groups.
• Microbiota diversity increased post-surgery but returned towards baseline levels by 12 months, with no group-specific differences.

Conclusions:

• Probiotic administration did not demonstrate a significant benefit over placebo for hepatic, inflammatory, or clinical outcomes at 6 and 12 months following LSG.
• The findings suggest that probiotics may not be effective in improving key outcomes after LSG in patients with NAFLD.
• Further research may be needed to explore specific probiotic strains or different patient populations.