How Manipulating the Microbiome Can Affect the Outcome Following Bariatric Surgery

Bariatric surgery alters the composition and function of the gut microbiome. An increase in microbial diversity and gene richness translates to changes in metabolomic profiles that corelate with weight loss and comorbidity resolution, even though mechanistic explanation is lacking. In addition to its role on metabolic improvement, gut microbiome may influence the occurrence and course of short-term complications such as surgical site infection and leaks. Obese patients have a baseline dysbiosis as a result of various factors, diet being the most important and easily modifiable before and after surgery. A high-fiber low-fat regime translates to a healthier gastrointestinal community and better outcomes. Probiotics, prebiotics and symbiotics and more novel strategies such as fecal microbiota transplant are under interrogation in this context.