A functional approach: Gut health after metabolic and bariatric surgery

Photo by Vitalii Pavlyshynets

Metabolic and bariatric surgery not only changes your anatomy and how your body absorbs nutrients, but studies show that it also affects the composition of microbes in your gut. There are several reasons for changes in gut health, motility, and functioning after surgery such as rapid weight loss, changes in nutritional habits, nutrient absorption, and altering of the digestive tract's pH. The change in microbiome after surgery is vital to long-term effectiveness of the surgery for weight loss and obesity treatment because they play an important role in nutrient absorption, digestion, and the body's energy balance. Therefore, optimizing gut health is great for overall health and quality of life!

As a reminder, here are the following signs and symptoms of poor gut health: 

• Upset stomach 

• Weight gain 

• Bloating and gas 

• Constipation and diarrhea 

• Constant fatigue and sleep problems 

• Skin irritations

These symptoms can originate from a low fiber, high processed foods, history of antibiotic use, poor stress management, inadequate sleep, and inadequate hydration… to name a few.

What can be done to improve gut health from a functional approach? 

Gut Health Nutrition 

Nutrition is key to building a healthy gut environment. If you want a thriving gut microbiome, you have to feed it well each day. Nourishing the digestive tract includes a variety of important aspects such as: 

• Consuming a whole foods diet including vegetables, fruits, legumes, whole grains, nuts and seeds - all of these great plant foods contain fiber, which our microbes need to support us

• Focusing on prebiotic fibers such as asparagus tips, onions, garlic, and leeks

• Incorporating probiotic fermented foods, such as sauerkraut, kimchi, yogurt, and kombucha

Gut health functional testing 

Gut microbiome functional testing allows us to lift the hood and take a deep dive into the gut microbiome. Using an at-home, comprehensive stool test can detect microbial imbalance within the gastrointestinal tract, which can affect metabolic, immune, and digestive health. Since metabolic and bariatric surgery can disrupt the microbiome, testing for imbalances can be very useful as one recovers from surgery. Especially if you’re experiencing bloating, gas, constipation or other digestive issues when other avenues have been explored with little to no symptom relief,  testing can be really helpful in taking a closer look. 

Gut Health Supplements 

Depending upon gut microbiome testing results, specific supplementation will be used to address any microbial imbalance directly. Supplementation should be individualized, however, here are some of our top choices to include: 

• Prebiotics and probiotics may be used in a supplemental form of additional support 

• Saccharomyces boulardii may help to support intestinal permeability and in treating diarrhea

• Grapefruit seed extract contains antibacterial and antifungal properties to help to support digestive 

• Ginger is used to soothe the digestive tract and improve symptoms of digestive distress

Gut Health Stress Management 

We know that our gastrointestinal tract and brain are so interconnected. This is why stress plays a huge role in maintaining a strong and healthy gut microbiome. A few ways to manage stress to improve gut health include:

• Deep breathing and mindfulness based meditation

• Increase in physical activity

• Maintaining adequate sleep patterns

Overall, it is important to optimize gut health before and after metabolic and bariatric surgery, but due to the rapid changes in microbiome function after surgery, if one is experiencing signs and symptoms of poor gut health we must dive deeper to find symptom relief and improve overall health. 

Interested in learning more about how we support gut health and weight loss surgery?

We’d love to work with you! Schedule a complimentary Meet + Greet session. We look forward to finding individualized solutions to fit your needs and being a partner with you in your bariatric journey.

Published: May 22nd, 2024.

This blog post was written by Amanda Sikkema MS, RD, LD, CSCS, a dietitian at Katie Chapmon Nutrition. She works with clients virtually and is accepting new clients.