Gut Health After Sleeve Gastrectomy

Gut health after sleeve gastrectomy is something rarely talked about. There has been a huge amount of research into the gut health and the microbiome in recent years. We’re starting to understand the importance of the millions of bacteria that live inside your gut for health. But what about gut health after sleeve gastrectomy? Thankfully, there has been some research here too. Read on to find out why your gut health is important and what you can do to look after it.

What does the research say?

In general, research has determined the millions of bacteria in our gut (the microbiome) acts like another organ which communicates with the rest of the body. Poor gut bacteria can be a contributor numerous health issues including obesity, diabetes, allergies, heart disease, inflammatory bowel diseases, mental health and arteriolosclerosis to name a few. Research is still trying to understand the link fully and look at the potential to use the gut microbiome as a treatment for some of those chronic diseases. Watch this space. 

A review published in 2019 looked at the effect of weight loss surgery on the gut microbiome and found there were some changes to the microbiome after surgery. The proposed reasons for these changes were the different food choices made after surgery but also anatomical changes which change nutrient absorption and transit time (particularly with bypass patients). These changes to food and nutrient intake alters the types of food the bacteria has to use so the gut microbiome changes. Another interesting change appears to be in the hunger hormones which may partly explain why appetite is reduced post op.

What can I do to improve my gut health?

There are two main areas to focus on:

1. Eating mainly unprocessed foods helps to foster a healthy gut microbiome. Unprocessed, high fibre foods like fruit, vegetables, legumes and grains provide prebiotics (food) that feeds the good bacteria. Fermented foods like sauerkraut, pickled veg, kefir and yoghurt are great options for gut health too.
2. Using probiotics after a sleeve also helps by recolonizing the gut with good bacteria. Probiotics also help to counteract any antiobiotic use after the surgery. In fact, a small study from Stanford that found patients who took a probiotic after a bypass lost more weight than those who didn’t take a probiotic supplement. They also found those taking the probiotic were less likely to have bacterial overgrowth (which can cause gut issues and food intolerances) and higher levels of B12 (a common deficiency after a bypass).

Where to find probiotics:

You don’t need to take a probiotic supplement, although it can be easier. Foods that have live or active are great probiotics and are really good foods to include regularly! Probiotic food options include:

• yoghurt
• sauerkraut
• kefir
• kimchi
• kombucha
• pickles
• miso
• cottage cheese
• natto
• buttermilk
• tempeh

If you want to take a probiotic supplement have a chat with your team as there are lots of options and different forms including pills, powders, liquids, chewables. When you do choose a probiotic supplement, be sure to read the pack for the specific dosage. 

The bottom line

To recap, we are still learning more about gut health after sleeve gastrectomy. However, there is some evidence that WLS does change the gut microbiome and this could be one of the reasons for diminished appetite after surgery. There is also some very limited research in bypass patients showing a positive association between taking a probiotic and weight loss as well as a reduction in B12 deficiency. To improve your gut health after surgery, include prebiotic and probiotic foods regularly and consider adding a probiotic supplement.