Probiotic Effect on Quality of Life, Bowel Habits and Weight Loss after Different Types of Bariatric Surgeries, a Randomized Controlled Trial

Introduction: Obesity is a complex health condition marked by an excessive accumulation of adipose tissue. Bariatric surgery continues to be the most efficacious intervention for attaining significant and enduring weight loss. The objective of our study was to assess a 6-month probiotics supplementation effect on quality of life (QoL), bowel habits, excess weight loss (EWL) and changes in stool composition and fecal Calprotectin in morbidly obese patients undergoing different types of bariatric surgeries. Methods: This prospective randomized controlled trial involved 200 cases underwent standardized bariatric procedures. Cases were randomized into 2 equal groups: Probiotic group received either Enterogermina® 6 billion sachets or Lacteol forte® sachets, one sachet twice daily for 6 months postoperatively. Results: Patients underwent one Anastomosis Gastric Bypass (OAGB) and Roux-en-Y gastric bypass (RYGB) had significantly higher EWL than those who had sleeve gastrectomy (SG) and gastric plication (4.7% (4.3:5.1) and 4.2% (3.7:4.7) vs. 3.1% (3.9:5.4) and 3.6% (4.5:5.3)). Also, patients underwent SG had significantly lower fecal calprotectin than those who had OAGB and RYGB (-61.06% (-70.1: -48.7) and -21.6% (-46.1: -4.9)-25.4% (-34.1: -5.7)), while patients didn’t show significant difference regarding their QOL or BHQ. Conclusion: The utilization of probiotics following bariatric surgery provides quantifiable advantages in QoL and weight reduction, and gastrointestinal inflammation, regardless of the surgical type. Although procedures like RYGB and OAGB yield superior weight loss, they may induce higher gut inflammation.