Probiotics may help gastric bypass patients

Hueytown, AL

Probiotics are sometimes prescribed by doctors to improve the body’s response to antibiotics by increasing levels of gut bacteria used by the body, but new research suggests they may play a complementary role in another treatment.

Researchers at Stanford University School of Medicine included probiotics as part of a regimen for patients who had recently undergone gastric bypass surgery.

They found that patients who used the "good bacteria" were more likely to lose weight than study subjects in the control group, and were also able to limit vitamin B12 deficiencies associated with the procedure.

Dr. John Morton, the study’s co-author, says that the research was initiated in response to obese patients who complained that it was difficult to eat properly after surgery because of the effects on the digestive tract.

"A lot of people aren’t aware that we all carry around a lot of bacteria in our intestines and that they’re extremely helpful in aiding digestion," he added. "And I thought, ‘Well, if we give these patients probiotics, then maybe we can improve these symptoms."

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Healthy Weight: Malabsorption makes vitamins necessary for gastric bypass

Billings, MT

Dear Dr. Baskett: Is it true that you have to take vitamins after weight loss surgery and that you have to do this for the rest of your life?

Actually, yes, that is true. After you have had bariatric surgery, regardless of the procedure - adjustable gastric banding (AGB) or Roux-en-Y gastric bypass - you are able to take in fewer calories. You are eating smaller amounts of food at any one time and you should not be snacking between meals. Therefore, you are at risk for nutritional deficiencies.

For example, after you have gastric bypass surgery, you often are able to eat only about a 1/2 cup of food at mealtime.

If you have had AGB, your capacity is also restricted to 1/2 cup to a cup of food at mealtime. Certainly, the decrease in calories leads to weight loss. This is your desired outcome. However, you are not able to get in all of the various nutrients that you need - such as calcium, iron, vitamin B12, and folate. Remember, that if you have had gastric bypass surgery, there is also a component of malabsorption. This can lead to further lack of essential nutrients.
Fortunately, this problem is readily resolved by taking a vitamin and mineral supplement on a daily basis. What is of most importance, though, is that you use a high-quality bariatric vitamin and mineral supplement.

There are several different brands that can be used and your bariatric team can make a recommendation for one that is suitable for you. These supplements have been designed specifically for the person who has had bariatric surgery and they provide the needed vitamins and minerals.

More common vitamins such as Flintstones or Centrum do NOT provide the essential nutrients that a bariatric surgical patient will need.

In addition, these products are not well absorbed. Although the bariatric supplements may cost a bit more, they are well worth the investment.

If your supplement is inadequate, long term nutritional and metabolic problems can occur.

Again, because you are eating less food, you are taking in less of the healthier fats called essential fatty acids - the omega 3's and 6's. Therefore, it is also important to supplement with fish oil capsules, flaxseed oil, or essential fatty acids (EFA).

Daily supplementation with bariatric vitamins/minerals and EFAs will help you to stay healthy after bariatric surgery. Don't shortchange yourself in this area.

Dr. Kathleen T. Baskett is medical director of the St. Vincent Healthcare Weight Management Clinic and author of "Moving Forward: The Weigh to a Healthier Weight."

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Probiotics after adult gastric bypass surgery improve GI function and increase weight loss, teen endoluminal vertical gastrop (EVG) study released

Washington, D.C.

A hefty dose of probiotics -- the "good" bacteria found in yogurts and supplements -- helps adult gastric-bypass patients lose even more weight, researchers are reporting.

The researchers didn't set out to see if probiotics could help the patients shed more pounds, said Dr. John M. Morton, associate professor at the Stanford University School of Medicine, who presented the findings this week at the Digestive Disease Week 2008 meeting in San Diego.

Morton wanted to improve the patients' gastrointestinal functioning. "Some patients [after bypass surgery] have a small amount of bacterial overgrowth [in the intestines]," he said, adding that can have an impact on gastrointestinal function and quality of life. So his team evaluated 42 patients who had undergone the bariatric surgery known as Roux-en-Y gastric bypass surgery, giving half of them probiotics daily and the other half no probiotics.

The researchers evaluated GI functioning and other measures and noted the patients' weight before surgery, after surgery, and at three and six months after beginning the probiotics program. The probiotics were given in supplement form -- 2.4 billion colonies of Lactobacillus daily.
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The probiotic group fared better in all categories at the six-month mark -- and also lost more weight. The probiotic group lost 70 percent of excess weight, compared to 66 percent for the control group.

The finding initially surprised Morton. "But other research has suggested that part of the obesity problem may be infectious. Some of the weight gain [in obese people] might be associated with bacteria," he said.

Asked if obese people, or those who have had bypass surgery, should eat yogurt, Morton said it probably couldn't hurt, but noted that 2.4 billion colonies ofLactobacillusis a large amount to get from yogurt.

Another study presented this week suggested that for severely overweight teens, a gentler weight-loss surgery may be possible. Dr. Roberto Fogel, of the Hospital de Clinicas Caracas, in Venezuela, presented the results of his pilot investigation of 12 teens, who underwent a surgery called endoluminal vertical gastroplasty, or EVG.

During the surgery, Fogel sutures the walls of the stomach, reducing the volume of the stomach but leaving a passageway for food. The procedure is done through the mouth; a scope containing a needle and sutures is inserted multiple times to perform the procedure.

After 60 to 90 minutes, the patient can go home, said Fogel, who does the surgery on an outpatient basis. Once the procedure is done, the patient gets full on very little food, he said.

At a six-month follow-up, Fogel found that all 12 patients had lost weight. The average body mass index, or BMI, was reduced from 38.1 to 27.8; a BMI of 30 or more is considered obese.

Fogel sees the new procedure, which he has performed on 331 teens since 2005, as a possible alternative to more invasive surgeries, or diet and exercise programs that prove ineffective for some obese teens.

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