Good afternoon/evening,

My name is Brad and I am a Microbiology research student at our state university. We are in opening talks for a "new" research direction, and I mentioned gastric bypass to the group of fellow researchers.

(Back Story), My mother, her identical twin sister, and another sister (also my aunt) ALL had gastric bypass surgery on the same day at the same hospital, in 2002. The results were amazing and I'm convinced that the surgery prolonged my mother's life by decades. So this topic is both interesting as well as near and dear to me.

Our research is mostly focused on how dietary changes affect the microbial life living in our stomachs and intestines. Within the last year, research as been pointing strongly toward overall body health being at the whim of our microbiome. Some of the research has been nothing short of miraculous.

What we are trying to further understand is how an artificial sweetener (aspartame, saccharin, etc) rich diet post surgery may or may not lead to desired weight loss within an estimated time frame. Also, if a probiotic rich diet post surgery leads to more or less desirable weight loss within a defined time frame.

Not to necessarily taint the waters with expected conclusions, but here is where we are LEANING. To date, research has been done regarding the affect of artificial sweeteners on the gut microbes. What the cursory research is showing us is that the artificial sweeteners favor a particular species of microbe living in your stomach. Since the species is favored, it is no longer held in check and their numbers begin to grow exponentially with the altered environment. These microbes are more capable of extracting greater nutrients (calories) from our eaten food. More absorbed calories COULD mean more weight gain or a slower weight loss.

The most interesting part is how they are changing this behavior. Researchers are delivering high dose antibiotics to the test subjects to kill off all (most, anyway) of the microbes in the body, both good and bad. They then inoculate the test subjects with known "good" bacteria which establish a foothold in the gut and proliferate. This action, coupled with a change in diet away from the microbe altering foods, has shown some promising results.

What we are trying to determine is, post gastric surgery, if there is a correlation with antibiotics given in recovery followed by the altered diet required by the surgery. My family well remembers the dietary changes we all undertook, but the idea of Probiotics wasn't even in an infancy phase. It was just too new.

So, the crux of this entire post, is about post surgical dietary guidelines and if they include probiotic use. Have probiotics or prebiotics been making their way into gastric management in the 15 years since my family delved into the procedure? To those whom perhaps used probiotics, did you notice a weight loss change at a different rate than expected?

Also, my mother had several other symptoms associated with her initial weight. Diabetes and hypertension were the two most prevalent. Within a short period of her surgery, before much weight loss, those symptoms had subsided. While we are not aware of any current links between hypertension and microbes, we cannot rule it out. I would be curious if people on this forum had similar results.

I welcome any comments and feedback,

Thanks,

Brad

My nutritionist has had me on a probiotic since I was pre-op. Also, the brand of shakes my surgical center pushes (Vitaleph) includes probiotics in the protein powder. Another thing to note is that most surgical programs really push yogurt, particularly Greek yogurt as a stable of your diet post-op.

I had gastric sleeve, not bypass. I was a revision from a lapband (implanted in 2001, removed 2011; sleeve in 2011).

My nutritionalist told me that there was strong evidence that people who take probiotics lose weight better and encouraged me to take them after my revision to sleeve. i bought them, but was so burned out on "pills" from the Vitamins that i never did. I lost 150# in 14 months and have been maintaining that loss for 3 years - so made it to a normal/goal weight without them.

I recently had another kind of surgery, had a complication and then an infection. I required Iv antibiotics plus was on a total of 3 different types of oral antibiotics. I was pretty sick actually. As i was wrapping up the antibiotics course, i decided to take probiotics as a preventive measure against yeast overgrowth or other imbalances. i feel fine, I feel no different.

So, my personal experience neither supports nor contradicts the benefits of probiotics.

I had borerline blood sugar - always in the 90s preop. It dropped to low normal levels quite quickly. Most of my blood work was otherwise pretty good - but i have read stories on these forums of very quick improvement of health conditions, faster than you might expect if it were just due to weight loss. I had borderline high blood pressure too, but that has always been more controlled by exercise vs my weight - not sure why.

Between my surgeon, nutritionist and nurse practitioner I have never been talked to about taking a probiotic, its never even been on the list of recommended supplements. The theory makes sense though, I might pick up a probiotic this weekend and start taking it and see if I notice a difference.

I was sleeved and haven't been taking probiotics but I eat a lot of yogurt.

Your research sounds interesting.

I would suggest that you talk with a variety of bariatric program nutritionists. They would be a great resource for anecdotal experience.

Many individuals who undergo surgery receive antibiotics in the hospital to prevent the wounds from getting infected. This kills the bad bacteria along with the good. Many doctors recommend the use of probiotics after surgery to restore the colonies of good bacteria in the gut which were destroyed by the antibiotics. After my RNY gastric bypass surgery, I took probiotics daily for a couple weeks. Often times individuals that do not take probiotics seem to suffer from bouts of diarrhea after surgery.

My nutritionist has had me on a probiotic since I was pre-op. Also, the brand of shakes my surgical center pushes (Vitaleph) includes probiotics in the Protein powder. Another thing to note is that most surgical programs really push yogurt, particularly Greek yogurt as a stable of your diet post-op.

That is quite good to know (the pushing of a yogurt rich diet). Depending upon the brand and such, they can have an extremely varied microbe content. I suppose an interesting test would be to break down post surgical success based upon which yogurt brands (and in turn, which microbes) lead to the most desirable outcome. That experiment would be much further down the line however LOL.

Speaking with my mother, she remembers being pushed into an extremely high protein diet post bypass, and told to avoid fruits and vegetables. I had forgotten that fact.

Thanks for the insight,

Brad

I had gastric sleeve, not bypass. I was a revision from a lapband (implanted in 2001, removed 2011; sleeve in 2011).

My nutritionalist told me that there was strong evidence that people who take probiotics lose weight better and encouraged me to take them after my revision to sleeve. i bought them, but was so burned out on "pills" from the Vitamins that i never did. I lost 150# in 14 months and have been maintaining that loss for 3 years - so made it to a normal/goal weight without them.

I recently had another kind of surgery, had a complication and then an infection. I required Iv antibiotics plus was on a total of 3 different types of oral antibiotics. I was pretty sick actually. As i was wrapping up the antibiotics course, i decided to take probiotics as a preventive measure against yeast overgrowth or other imbalances. i feel fine, I feel no different.

So, my personal experience neither supports nor contradicts the benefits of probiotics.

I had borerline blood sugar - always in the 90s preop. It dropped to low normal levels quite quickly. Most of my blood work was otherwise pretty good - but i have read stories on these forums of very quick improvement of health conditions, faster than you might expect if it were just due to weight loss. I had borderline high blood pressure too, but that has always been more controlled by exercise vs my weight - not sure why.

Thanks for the info. I have been reading through several online forums regarding different weight loss surgeries, and I too find the common story about ancillary health problems rectifying at a rate which seems earlier than you would expect.

I believe the probiotics are a good move after a heavy antibiotic dose. Though antibiotics can vary in how they work, they generally attack the ability of the bacteria to make peptidoglycan, OR they target a 30s receptor on the ribosomes. Since bacteria are a 70s organism, and we humans are an 80s, the antibiotic can attack the infection and leave the host (us) unharmed.

Of course, yeast are not a 70s bacteria (they are 80s), so the antibiotics don't bother them. Without competition from other microbes, the yeast can have a party and multiply to dangerous levels fairly quickly.

Not that that is particularly relevant ( or that you asked), it is still interesting.

Thanks again,

Brad

Between my surgeon, nutritionist and nurse practitioner I have never been talked to about taking a probiotic, its never even been on the list of recommended supplements. The theory makes sense though, I might pick up a probiotic this weekend and start taking it and see if I notice a difference.

Thanks for the reply. I see your profile listed as Idaho. Howdy from across the border (Wyoming).

I believe the data is too early to say whether probiotics are of any help, so I would expect some health professionals to be waiting for more concrete data to come forth before making recommendations. Prior to returning into the world of academia I spent nearly 14 years as a paramedic. Though there were some excellent advances made in medicine during my time, there were at least just as many which ended up being useless. Due diligence requires wading through the pile and coming up with a gem.

Enjoy Idaho,

Brad

I was sleeved and haven't been taking probiotics but I eat a lot of yogurt.

Your research sounds interesting.

I would suggest that you talk with a variety of bariatric program nutritionists. They would be a great resource for anecdotal experience.

Good evening,

I notice a recurring theme of folks eating a bunch of yogurt. This is something we would have to include in any research we may undertake.

If this is something we end up delving into, my first step would be to contact nutritionists and pick their brain. Fortunately we are close to Colorado and the plethora of specialists which could help us. All of the folks involved in my mother's surgery have since retired, so I have fallen out of the "local" bypass scene.

Though these ideas are in their infancy, hopefully in 10 years time they can really help folks undertaking this path.

Thanks,

Brad

Many individuals who undergo surgery receive antibiotics in the hospital to prevent the wounds from getting infected. This kills the bad bacteria along with the good. Many doctors recommend the use of Probiotics after surgery to restore the colonies of good bacteria in the gut which were destroyed by the antibiotics. After my RNY gastric bypass surgery, I took probiotics daily for a couple weeks. Often times individuals that do not take probiotics seem to suffer from bouts of diarrhea after surgery.

Howdy,

I hadn't considered the idea of diarrhea management post surgery to include probiotics. In speaking with my aunts, they were all under the impression that more probiotics lead to worsening diarrhea, Though, they are nearly two decades post surgery and antibiotics, so they may not necessarily relate.

With the awesome treatment of C-diff by using fecal transplant, I could see a time where post surgical care includes doses of poo filled capsules to keep everything smooth. Not such a pleasant thought

Thanks for the post,

Brad

I had my surgery with Dr. Ariel Ortiz in Mexico over two years ago. Even then His dietician STRONGLY recommended the use of probiotics. She wanted us on drinkable yogurts with live cultures starting 3 days postop. They also offer and encourage their patients to use their line of bariatric Vitamins that include a probiotic supplement. I did not use their line, but I do take whole food based vitamins that include prebiotics, probiotics and digestive enzymes. I also eat Greek yogurt with live cultures every day.

I lost over 100% of my excess weight and have kept it off for two years. I have no idea how much of an impact the probiotics played because it's something I've taken from the very beginning.

My nutritionist has had me on a probiotic since I was pre-op. Also, the brand of shakes my surgical center pushes (Vitaleph) includes probiotics in the Protein powder. Another thing to note is that most surgical programs really push yogurt, particularly Greek yogurt as a stable of your diet post-op.

That is quite good to know (the pushing of a yogurt rich diet). Depending upon the brand and such, they can have an extremely varied microbe content. I suppose an interesting test would be to break down post surgical success based upon which yogurt brands (and in turn, which microbes) lead to the most desirable outcome. That experiment would be much further down the line however LOL.

Speaking with my mother, she remembers being pushed into an extremely high protein diet post bypass, and told to avoid fruits and vegetables. I had forgotten that fact.

Thanks for the insight,

Brad

We are all encouraged to eat a high protein/low carb diet. Yogurt is a great option immediately post op because of it's soft consistency. Some of us are even allowed it in the "liquid" phases. It remains a good option later on as well, due to its high protein content and low carbs/sugar.

Another thing that might be interesting to explore is the prebiotic Fiber content of many high Protein Bars. Many use isomalto-oligosaccharides and a major brand, Quest, just switched to soluble corn fiber. I was an avid Quest Bar eater until the switch and my gut bacteria definitely didn't take the switch well. I became HORRIBLY bloated and flatulent. I couldn't even be in the same room with myself it was so bad. I had to switch to another brand that was still using isomalto-oligosaccharides.

....

Howdy,

I hadn't considered the idea of diarrhea management post surgery to include probiotics. In speaking with my aunts, they were all under the impression that more probiotics lead to worsening diarrhea, Though, they are nearly two decades post surgery and antibiotics, so they may not necessarily relate.

With the awesome treatment of C-diff by using fecal transplant, I could see a time where post surgical care includes doses of poo filled capsules to keep everything smooth. Not such a pleasant thought

Thanks for the post,

Brad

My post WLS story gets even more complicated by the fact that I did have a C. diff infection develop 2 months postop. My PCP, gastroenterologist and the infectious disease specialist I saw all agreed it was likely a combination of my high risk of previous exposure (I am a vet tech and have treated hundreds of animals with clostridial diarrhea over the last 12 years), my recent GI surgery, the fact I was taking a PPI, and most importantly the clindamycin I was given for a tooth root abcess 2 weeks prior to the diarrhea starting.

After two months of failed treatment with metronidazole, vancomycin and MASS quantities of probiotics, I finally had a fecal transplant. Instant cure, BTW! And it just so happens that my donor is a very thin person, so who knows how much of my successful weight loss can be attributed to her "skinny flora" vs my VSG?!

But one thing's for sure....I will never be taking antibiotics again. I actually refused them when I had my gallbladder removed, despite my surgeon's protocol. He made me sign a AMA form to that effect.