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Gut Microbiota Imbalance Can Be Associated with Non-malabsorptive Small Bowel Shortening Regardless of Blind Loop

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Abstract

Introduction

Some traditional bariatric surgery procedures may lead to functional gut shortening, which may unsettle the fine-tuned gastrointestinal physiology and affect gut microbiota balance.

Purpose

Evaluate the gut microbiota behavior in rat models facing gut shortening due to intestinal bypass.

Materials and Methods

Wistar rats (n = 17) were randomly distributed in three groups: (1) sham group (n = 5); (2) blind loop group (n = 6); and (3) resection group (n = 6). Intestinal samples and feces were analyzed to measure bacterial concentrations (small intestinal bacterial overgrowth—SIBO) 12 weeks after the experimental procedures. Bacterial translocation (BT) was investigated in the mesenteric lymph node (MLN), liver, spleen, and lung of the animals. In addition, inflammatory aspects were investigated in their liver and small bowel through histological analysis.

Results

Regardless of blind loop, gut shortening groups recorded similar high level of bacterial concentrations in intestine compartments, greater than that of the sham group (p ≤ 0.05). BT was only observed in the MLN of gut shortening models, with higher percentage in the blind loop group (p ≤ 0.05). The gut and liver histopathological analysis showed similar low-grade chronic inflammation in both gut shortening groups, likely associated with SIBO/BT events.

Conclusion

Sustained SIBO/BT was associated with proximal gut shortening in half regardless of blind loop, whereas the GI tract’s ability to restore gut microbiota balance after a surgical challenge on the small bowel appears to be linked to the functional remaining gut.

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Authors and Affiliations

  1. Department of Gastrointestinal Surgery, Marilia Medicine School, 12 Santa Helena St., Marilia, Sao Paulo, 17515-410, Brazil

    Eduardo Lemos de Souza Bastos

  2. Experimental Research Laboratory, Federal University of Sao Paulo, Sao Paulo, Brazil

    Ana Maria Alvim Liberatore

  3. Department of Morphology and Genetics, Federal University of Sao Paulo, Sao Paulo, Brazil

    Roberto Carlos Tedesco

  4. Department of Surgery and Experimental Research Laboratory, Federal University of Sao Paulo, Sao Paulo, Brazil

    Ivan Hong Jun Koh

Authors
  1. Eduardo Lemos de Souza Bastos
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  2. Ana Maria Alvim Liberatore
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  3. Roberto Carlos Tedesco
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  4. Ivan Hong Jun Koh
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Corresponding author

Correspondence to Eduardo Lemos de Souza Bastos.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All applicable institutional and national guidelines for the care and use of animals were followed. The present study was previously approved by Local Ethics Committee (UNIFESP – 0215/11).

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Bastos, E.L.S., Liberatore, A.M.A., Tedesco, R.C. et al. Gut Microbiota Imbalance Can Be Associated with Non-malabsorptive Small Bowel Shortening Regardless of Blind Loop. OBES SURG 29, 369–375 (2019). https://doi.org/10.1007/s11695-018-3540-1

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  • DOI: https://doi.org/10.1007/s11695-018-3540-1

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