Alteraciones en la microbiota gastrointestinal después de la cirugía bariátrica

Autores/as

Palabras clave:

Microbiota intestinal, disbiosis, metabolismo, antibióticos, cirugía bariátrica.

Resumen

La cirugía bariátrica puede generar importantes cambios en la microbiota intestinal, donde puede llegar a mejorar su funcionalidad y ampliar su diversidad, lo cual impacta positivamente en el metabolismo y facilita el alcanzar las metas terapéuticas del procedimiento. Sin embargo, estos cambios también pueden conllevar riesgos como infecciones, alteración en la absorción de nutrientes, anemia o implicaciones inmunológicas. El uso adecuado de profilaxis antimicrobiana es clave para prevenir infecciones posquirúrgicas, y se ha demostrado que el uso de probióticos puede llegar a ser un complemento útil para mejorar la salud intestinal, la respuesta inflamatoria y los resultados metabólicos a largo plazo. El conocimiento del rol de la microbiota dentro de la cirugía bariátrica se vuelve indispensable, ya que esta se postula como un actor esencial dentro de los resultados posquirúrgicos de los pacientes.

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Biografía del autor/a

  • Isabella Gómez-Arismendy, Universidad Pontificia Bolivariana (Colombia).

    Estudiante de Medicina.

  • Mariana Lopera-Osorno, Universidad Pontificia Bolivariana (Colombia).

    Estudiante de Medicina.

Referencias

1. Zafar H, Saier MH. Gut Bacteroides species in health and disease. Gut Microbes. 2021; 13(1):1-20. DOI: 10.1080/19490976.2020.1848158.

2. Gasmi A, Bjørklund G, Mujawdiya PK, Semenova Y, Dosa A, Piscopo S, et al. Gut microbiota in bariatric surgery. Crit Rev Food Sci Nutr. 2023; 63(28):9299-314. DOI: 10.1080/10408398.2022.2067116.

3. Sun LJ, Li JN, Nie YZ. Gut hormones in microbiota-gut-brain cross-talk. Chin Med J (Engl). 2020; 133(7):826-33. DOI: 10.1097/CM9.000000000000070.

4. Angelini G, Russo S, Mingrone G. Incretin hormones, obesity and gut microbiota. Peptides. 2024; 178:171216. DOI: 10.1016/j.peptides.2024.171216.

5. Sandoval DA, Patti ME. Glucose metabolism after bariatric surgery: implications for T2DM remission and hypoglycaemia. Nat Rev Endocrinol. 2023; 19(3):164-76. DOI: 10.1038/s41574-022-00757-5.

6. Arterburn DE, Telem DA, Kushner RF, Courcoulas AP. Benefits and Risks of Bariatric Surgery in Adults: A Review. JAMA. 2020; 324(9):879-87. DOI: 10.1001/jama.2020.12567.

7. Dewantoro D, Davenport R, Goh JY, Bakhshi A, Ali A. The Effect of Different Types of Bariatric Surgery on Levothyroxine Requirement in Hypothyroid Bariatric Patients. Cureus. 2022; 14(6):e26165. DOI: 10.7759/cureus.26165.

8. Yadav J, Liang T, Qin T, Nathan N, Schwenger KJP, Pickel L, et al. Gut microbiome modified by bariatric surgery improves insulin sensitivity and correlates with increased brown fat activity and energy expenditure. Cell Rep Med. 2023; 5:101051. DOI: 10.1016/j.xcrm.2023.101051.

9. El Ansari W, Elhag W. Weight Regain and Insufficient Weight Loss After Bariatric Surgery: Definitions, Prevalence, Mechanisms, Predictors, Prevention and Management Strategies, and Knowledge Gaps-a Scoping Review. Obes Surg. 2021; 31(4):1755-66. DOI: 10.1007/s11695-020-05160-5.

10. Anhê FF, Zlitni S, Zhang SY, Choi BS, Chen CY, Foley KP, et al. Human gut microbiota after bariatric surgery alters intestinal morphology and glucose absorption in mice independently of obesity. Gut. 2023 ;72(3):460-71.

11. Geng J, Ni Q, Sun W, Li L, Feng X. The links between gut microbiota and obesity and obesity related diseases. Biomed Pharmacother. 2022 ;147:112678. DOI: 10.1016/j.biopha.2022.112678.

12. Gibiino G, Binda C, Cristofaro L, Sbrancia M, Coluccio C, Petraroli C. Dysbiosis and Gastrointestinal Surgery: Current Insights and Future Research. Biomedicines. 2022; 10(10):2532. DOI: 10.3390/biomedicines10102532.

13. Shi H, Li J. MAGs-based genomic comparison of gut significantly enriched microbes in obese individuals pre- and post-bariatric surgery across diverse locations. Front Cell Infect Microbiol. 2025; 1485048. DOI: 10.3389/fcimb.2025.1485048.

14. Wilson RB, Lathigara D, Kaushal D. Systematic Review and Meta-Analysis of the Impact of Bariatric Surgery on Future Cancer Risk. Int J Mol Sci. 2023; 24(7):6192. DOI: 10.3390/ijms24076192.

15) Kędzierska K, Dymkowski M, Niegowska W, Humięcka M, Sawicka A, Walczak I, et al. Iron Deficiency Anemia Following Bariatric Surgery: A 10-Year Prospective Observational Study. Nutrients. 2025; 17(2):339. DOI: 10.3390/nu17020339.

16. Różańska-Walędziak A, Wyszomirski K, Kaszuba M, Mierzejewska A, Skopińska E, Walędziak M. Bariatric Surgery and Metabolic Status. Medicina (Kaunas). 2024; 20;60(9):1532. DOI: 10.3390/medicina60091532.

17. Walmsley R, Chong L, Hii MW, Brown RM, Sumithran P. The effect of bariatric surgery on the expression of gastrointestinal taste receptors: A systematic review. Rev Endocr Metab Disord. 2024; 25(2):421-46. DOI: 10.1007/s11154-023-09865-7.

18. Aydin Ö, Meijnikman AS, de Jonge PA, van Stralen K, Börger H, Okur K, et al.Post-Bariatric Hypoglycemia: an Impaired Metabolic Response to a Meal. Obes Surg. 2024; 10:3796-806. DOI: 10.1007/s11695-024-07309-y.

19. Hierons SJ, Abbas K, Sobczak AIS, Cerone M, Smith TK, Ajjan RA, et al. Changes in plasma free fatty acids in obese patients before and after bariatric surgery highlight alterations in lipid metabolism. Sci Rep. 2022; 12(1):15337. DOI: 10.1038/s41598-022-19657-9.

20. Zhao S, Lin H, Li W, Xu X, Wu Q, Wang Z. Post sleeve gastrectomy-enriched gut commensal Clostridia promotes secondary bile acid increase and weight loss. Gut Microbes. 2025; 1:2462261. DOI: 10.1080/19490976.2025.2462261.

21. Hankir MK. Gut microbiota turn up the heat after bariatric surgery. Cell Stress. 2023; 7(10):90-4. DOI: 10.15698/cst2023.10.290.

22. Shera S, Katzka W, Yang JC, Chang C, Arias-Jayo N, Lagishetty V, et al. Bariatric-induced microbiome changes alter MASLD development in association with changes in the innate immune system. Front Microbiol. 2024; 1407555. DOI: 10.3389/fmicb.2024.1407555.

23. Lopes KG, Romagna EC, da Silva DS, da Costa Tavares Bezerra M, Leal PRF, da Silva Soares Pinto JE, et al.Metabolic and Inflammatory Profiles of Post-Bariatric Patients with Weight Recidivism. Obes Surg. 2022; 6:1849-55. DOI: 10.1007/s11695-022-06025-9.

24. Middleton AO, Byrne JP, Calder PC. The influence of bariatric (metabolic) surgery on blood polyunsaturated fatty acids: A systematic review. Clin Nutr ESPEN. 2022; 48:121-40. DOI: 10.1016/j.clnesp.2022.02.001.

25. Vaz M, Pereira SS, Monteiro MP. Metabolomic signatures after bariatric surgery - a systematic review. Rev Endocr Metab Disord. 2022; 23(3):503-19. DOI: 10.1007/s11154-021-09695-5.

26. Mele C, Caputo M, Ferrero A, Daffara T, Cavigiolo B, Spadaccini D,et al. Bone Response to Weight Loss Following Bariatric Surgery. Front Endocrinol (Lausanne).2022; 13:921353. DOI: 10.3389/fendo.2022.921353.

27. Leyderman M, Wilmore JR, Shope T, Cooney RN, Urao N. Impact of intestinal microenvironments in obesity and bariatric surgery on shaping macrophages. Immunometabolism (Cobham). 2023; 5(4):e00033. DOI: 10.1097/IN9.0000000000000033.

28. Reczkowicz J, Mika A, Antosiewicz J, et al. Bariatric Surgery Induced Changes in Blood Cholesterol Are Modulated by Vitamin D Status. Nutrients. 2022; 14(10):2000. DOI: 10.3390/nu14102000.

29. Lund RS, Hertel JK, Sandbu R, Hjelmesæth J. Patient complaints following bariatric surgery 2012-18. Tidsskr Nor Laegeforen. 2020; 140(16). DOI: 10.4045/tidsskr.20.0194.

30. Ferraz AAB, Siqueira LT, Campos JM, Araújo Jr GC, Martins Filho ED, Ferraz EM. Antibiotic prophylaxis in bariatric surgery: a continuous infusion of cefazolin versus ampicillin/sulbactam and ertapenem. Arq Gastroenterol. 2015; 52(2):83-87.

31. Pugliese G, Liccardi A, Graziadio C, Barrea L, Muscogiuri G, Colao A. Obesity and infectious diseases: pathophysiology and epidemiology of a double pandemic condition. Int J Obes (Lond). 2022; 46(3):449-65. DOI: 10.1038/s41366-021-01035-6.

32. Chopra T, Marchaim D, Lynch Y, et al. Epidemiology and outcomes associated with surgical site infection following bariatric surgery. Am J Infect Control. 2012; 40(9):815-9.

33. Ferraz ÁAB, Santa-Cruz F, Edmiston CE Jr. Antibiotic Prophylaxis in Bariatric Surgical Procedures: Is There an Ideal Antimicrobial Agent? Surg Infect (Larchmt). 2020; 21(8):654-8. DOI: 10.1089/sur.2019.275.

34. Silva AFD, Mendes KDS, Ribeiro VDS, Galvão CM. Risk factors for the development of surgical site infection in bariatric surgery: an integrative review of literature. Rev Lat Am Enfermagem. 2023; 31:e3798. DOI: 10.1590/1518-8345.6309.3798.

35. Bratzler DW, Dellinger EP, Olsen KM, Perl TM, Auwaerter PG, Bolon MK, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm. 2013; 70(3):195-283.

36. Freeman JT, Anderson DJ, Hartwig MG, Sexton DJ. Surgical site infections following bariatric surgery in community hospitals: A weighty concern? Obes Surg. 2011; 21(7):836-40.

37. Chen X, Brathwaite CE, Barkan A, et al. Optimal Cefazolin Prophylactic Dosing for Bariatric Surgery: No Need for Higher Doses or Intraoperative Redosing. Obes Surg. 2017; 27(3):626-29. DOI: 10.1007/s11695-016-2331-9.

38. Dang JT, Szeto VG, Elnahas A, et al. Canadian consensus statement: enhanced recovery after surgery in bariatric surgery. Surg Endosc. 2020; 34(3):1366-75. DOI: 10.1007/s00464-019-06911-x.

39. Chopra T, Zhao JJ, Alangaden G, et al. Preventing surgical site infections after bariatric surgery: Value of perioperative antibiotic regimens. Expert Rev Pharmacoecon Outcomes Res 2010; 10:317–28.

40. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. Am J Infect Control. 1999; 27(2):97–132.

41. Jacobson R, Terranella S, Booker C, Khalid S, Torquati A, Omotosho P. The Impact of Perioperative Antibiotic Prophylaxis on Weight Loss Following Laparoscopic Sleeve Gastrectomy. J Laparoendosc Adv Surg Tech A. 2020; 30(9):998-1000. DOI: 10.1089/lap.2020.0449.

42. Jernberg C, Lofmark S, Edlund C, et al. Long-term ecological impacts of antibiotic administration on the human intestinal microbiota. ISME J. 2007; 1:56–66.

43. Daghmouri MA, Chaouch MA, Yang W, et al.Probiotics in bariatric surgery ensure greater lipids and glycemic profile with no effect on anthropometric measurements and inflammatory markers: A systematic review and meta-analysis of RCT. Surgery Open Digestive Advance. 2022; 7:100061. DOI:10.1016/j.soda.2022.100061.

44. Woodard GA, Encarnacion B, Downey JR, et al. Probiotics improve outcomes after Roux-en-Y gastric bypass surgery: a prospective randomized trial. J Gastrointest Surg. 2009; 13(7):1198-204. DOI: 10.1007/s11605-009-0891-x.

45. Wang Y, Zheng Y, Kuang L, et al. Effects of probiotics in patients with morbid obesity undergoing bariatric surgery: a systematic review and meta-analysis. Int J Obes (Lond). 2023; 47(11):1029-42. DOI: 10.1038/s41366-023-01375-5.

46. Sherf-Dagan S, Zelber-Sagi S, Zilberman-Schapira G, et al. Probiotics administration following sleeve gastrectomy surgery: a randomized double-blind trial. Int J Obes (Lond). 2018; 42(2):147-55. DOI: 10.1038/ijo.2017.210.

47. Ferreira de Sousa D, Bresciani L.Effects of the Use of Probiotics in Post-Bariatric Surgery Obesity: Meta-Umbrella of Systematic Reviews.Obesities. 2024; 4: 491- 508. DOI: 10.3390/obesities4040039.

48. Cook J, Lehne C, Weiland A, Archid R, Ritze Y, et al. Gut Microbiota, Probiotics and Psychological States and Behaviors after Bariatric Surgery-A Systematic Review of Their Interrelation. Nutrients. 2020; 12(8):2396. DOI: 10.3390/nu12082396.

49. Damms-Machado A, Mitra S, Schollenberger AE, et al. Effects of surgical and dietary weight loss therapy for obesity on gut microbiota composition and nutrient absorption. Biomed Res Int. 2015; 2015:806248. DOI: 10.1155/2015/806248.

50. Zhang Y, Yan T, Xu C, Yang H, Zhang T, Liu Y. Probiotics Can Further Reduce Waist Circumference in Adults with Morbid Obesity after Bariatric Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Evid Based Complement Alternat Med. 2021. DOI: 10.1155/2021/5542626.

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Publicado

2026-06-30

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Revisión de la literatura

Cómo citar

Alteraciones en la microbiota gastrointestinal después de la cirugía bariátrica. (2026). Salutem Scientia Spiritus, 12(2), 68-73. http://revistas.javerianacali.edu.co/index.php/salutemscientiaspiritus/article/view/1859