Effects of early postoperative synbiotic supplementation on gastrointestinal outcomes after sleeve gastrectomy: A randomized controlled trial.

BACKGROUND AND AIMS: Bariatric surgery induces significant alterations in gastrointestinal physiology and gut microbiota, often leading to postoperative gastrointestinal symptoms. This study aimed to evaluate the effects of early postoperative synbiotic supplementation on gastrointestinal outcomes and body composition in patients undergoing sleeve gastrectomy.

METHODS

This prospective randomized controlled study included 60 patients undergoing sleeve gastrectomy. Participants were randomly assigned to receive either synbiotic supplementation (partially hydrolyzed guar gum and Lactobacillus rhamnosus GG) or standard postoperative care for 12 weeks. Gastrointestinal symptoms, physical activity, and body composition were assessed preoperatively and at postoperative weeks 4 and 12. Changes over time and between groups were analyzed using repeated measures ANOVA.

RESULTS

Significant improvements in constipation-related outcomes were observed in the intervention group compared to controls, particularly in stool obstruction and colonic inertia scores. A significant time × group interaction was observed for constipation scores (p < 0.001), indicating a differential effect of the intervention over time. While both groups showed significant reductions in body weight and body composition parameters over time, no significant between-group differences were detected.

CONCLUSIONS

This randomized controlled trial suggests that early postoperative synbiotic supplementation may improve gastrointestinal outcomes, particularly constipation, following sleeve gastrectomy. Synbiotic use may represent a supportive strategy in postoperative nutritional management. Further large-scale and long-term studies are needed to confirm these findings.

CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT07051824.