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

2026-08
Clinical nutrition (Edinburgh, Scotland) 63
- Ayten Altunsaray
- Birgül Dağ
- Ayhan Dağ

PubMed: 42400993
DOI: 10.1016/j.clnu.2026.106717

Study Design

Type: Randomized Controlled Trial (RCT)
Sample size: n = 60
Population: 60 patients undergoing sleeve gastrectomy
Methods: prospective randomized controlled study, synbiotic supplementation (partially hydrolyzed guar gum and Lactobacillus rhamnosus GG) or standard postoperative care for 12 weeks
Blinding: Open-label
Duration: 12 weeks
Funding: Unclear

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.

Research Insights

Lactobacillus rhamnosus GG→Reduced Body Composition
While both groups showed significant reductions in body weight and body composition parameters over time, no significant between-group differences were detected.
Effect
Neutral
Effect size
Small
Lactobacillus rhamnosus GG→Reduced Body Weight
While both groups showed significant reductions in body weight and body composition parameters over time, no significant between-group differences were detected.
Effect
Neutral
Effect size
Small
Lactobacillus rhamnosus GG→Reduced Colonic Inertia Score
Significant improvements in constipation-related outcomes were observed in the intervention group compared to controls, particularly in stool obstruction and colonic inertia scores.
Effect
Beneficial
Effect size
Small
Lactobacillus rhamnosus GG→Reduced Constipation Score
A significant time × group interaction was observed for constipation scores (p < 0.001), indicating a differential effect of the intervention over time.
Effect
Beneficial
Effect size
Small
Lactobacillus rhamnosus GG→Reduced Stool Obstruction Score
Significant improvements in constipation-related outcomes were observed in the intervention group compared to controls, particularly in stool obstruction and colonic inertia scores.
Effect
Beneficial
Effect size
Small