Laparoskopik sleeve gastrektomi sonrası probiyotik takviyesinin konstipasyon ve gastrointestinal yaşam kalitesi üzerine etkisi

Yıl 2021, Cilt: 6 Sayı: 3, 117 - 122, 09.12.2021

Nida Yıldız , Murat Baş , Halil Coşkun Nazlı Batar , Erkan Yardımcı

Öz

Amaç: Bu çalışmada, Laparoskopik Sleeve Gastrektomi (LSG) sonrası probiyotik takviyesinin, konstipasyon ve gastrointestinal yaşam kalitesi üzerine erken dönem etkisinin araştırılması amaçlanmıştır.
Yöntemler: Bu çalışma, prospektif, randomize klinik çalışmadır. Katılımcıları Bariatriklab Obezite ve Metabolik Cerrahi Merkezi’ne LSG için başvuran bireyler oluşturmaktadır. Tüm hastalar, basit randomizasyon kullanılarak randomize örnekleme ile probiyotik ve kontrol olmak üzere 2 gruba ayrıldı. Probiyotik grubu, LSG sonrası 6 hafta boyunca probiyotik takviyesi olarak Bifidobacterium animalis lactis BB-12 suşunu kullandı. Hastaların, LSG öncesi ve sonrası 2.hafta, 4.hafta, 6.haftanın sonunda Gastrointestinal Semptom Derecelendirme Ölçeği (GSRS), Konstipasyon Ciddiyet Ölçeği (CSI), Konstipasyon Yaşam Kalitesi Ölçeği (PAC-QOL), Bristol Dışkı Formu Skalası (BSFS), Gastrointestinal Yaşam Kalitesi İndeksi (GIQLI) kaydedildi.
Bulgular: Probiyotik grubun yaş ortalaması 37,00±8,92 (18 kadın, 12 erkek), kontrol grubunun yaş ortalaması 41,03±11,29 (23 kadın, 7 erkek) idi. CSI (16,50 ± 14,76 ile 31,37 ± 15,34), PAC-QOL (58,53 ± 12,59 ile 72,30 ± 19,70), GSRS (26,83 ± 9,14 ile 37,93 ± 16,59) ve toplam puan ortalaması kontrol grubuna göre daha düşük, GIQLI toplam puan ortalaması (147,50 ± 11,79 ile 136,87 ± 18,98) daha yüksek bulundu (p <0,05).
Sonuç: LSG sonrası erken dönemde probiyotik takviyesi alan grupta, kontrol grubuna kıyasla konstipasyon ve gastrointestinal yaşam kalitesinde iyileşmeler gözlenmiştir.

Anahtar Kelimeler

Bariatrik cerrahi, gastrointestinal yaşam kalitesi, konstipasyon, sleeve gastrektomi, probiyotik

Effect of probiotic supplementation after laparoscopic sleeve gastrectomy on constipation and gastrointestinal quality of life

Öz

Aim: In this study, we aimed to investigate the early effect of probiotic supplementation after Laparoscopic Sleeve Gastrectomy (LSG) on constipation and gastrointestinal quality of life compared to control group.
Methods: This study was a prospective, randomized clinical trial. Participants were recruited to Bariatriklab Obesity and Metabolic Surgery Center for LSG. All patients were divided into 2 groups as probiotic and control by using simple randomization. The probiotic group consumed Bifidobacterium animalis lactis BB-12 strain as a probiotic supplement during 6 weeks after LSG. Gastrointestinal Symptom Rating Scale (GSRS), Constipation Severity Instrument (CSI), Patient Assessment of Constipation Quality of Life Scale (PAC-QOL), Bristol Stool Form Scale (BSFS), Gastrointestinal Quality of Life Index (GIQLI) of the patients were recorded before LSG and at the 2nd, 4th, 6th weeks after LSG.
Results: The probiotic group had an average age of 37.00±8.92 years (18 female, 12 male), the control group had an average age of 41.03±11.29 years (23 female, 7 male). CSI (16.50 ± 14.76 vs. 31.37 ± 15.34), PAC-QOL (58.53 ± 12.59 vs 72.30 ± 19.70), GSRS (26.83 ± 9.14 vs. 37.93 ± 16.59) and total score mean were lower compared to the control group, GIQLI total score average (147.50 ± 11.79 vs 136.87 ± 18.98) was found higher (p <0.05) in probiotic group.
Conclusion: Probiotic supplementation improved the constipation and gastrointestinal quality of life in the early post-LSG period in the probiotic group compared to the control group.

Anahtar Kelimeler

Bariatric surgery, gastrointestinal quality of life, constipation, sleeve gastrectomy, probiotics

Kaynakça

• Bray GA, Bouchard C. Handbook of Obesity-Volume 2. 4th Ed. London: CRC Press; 2014.
• Crawford C, Gibbens K, Lomelin D, Krause C, Simorov A, Oleynikov D. Sleeve gastrectomy and anti-reflux procedures. Surg Endosc. 2017;31:1012-21.
• Sağlam F, Güven H. Surgical Treatment of Obesity. Eur Arc Med Res. 2014;30:60-5.
• Kalarchian MA, King WC, Devlin MJ, Marcus MD, Garcia L, Chen JY, et al. Psychiatric Disorders and Weight Change in a Prospective Study of Bariatric Surgery Patients: A 3-Year Follow-Up. Psychosom Med. 2016;78:373-81.
• Chen JC, Lee WJ, Tsou JJ, Liu TP, Tsai PL. Effect of probiotics on postoperative quality of gastric bypass surgeries: A prospective randomized trial. Surg Obes Relat Dis. 2016;12:57–61.
• Poves I, Cabrera M, Maristany C, Coma A, Ballesta-López C. Gastrointestinal quality of life after laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2006;16:19–23.
• Sherf Dagan S, Goldenshluger A, Globus I, Schweiger C, Kessler Y, Kowen Sandbank G, Ben-Porat T, et al. Nutritional Recommendations for Adult Bariatric Surgery Patients: Clinical Practice. Adv Nutr. 2017;8:382-94.
• Chmielewska A, Szajewska H. Systematic review of randomized controlled trials: Probiotics for functional constipation. World J Gastroenterol. 2010;16:69–75.
• Eskesen D, Jespersen L, Michelsen B, Whorwell PJ, Müller-Lissner S, Morberg CM. Effect of the probiotic strain Bifidobacterium animalis subsp. lactis, BB-12 ®, on defecation frequency in healthy subjects with low defecation frequency and abdominal discomfort: A randomized, double-blind, placebo-controlled, parallel-group trial. Br J Nutr. 2015;114:1638-46.
• Wagner NRF, Zaparolli MR, Cruz MRR, Schieferdecker MEM, Campos ACL. Postoperative changes in intestinal microbiota and use of probiotics in Roux-en-Y gastric bypass and sleeve vertical gastrectomy: An integrative review. Arq Bras Ciru Dig. 2018;31:1400.
• Revicki DA, Wood M, Wiklund I, Crawley J. Reliability and validity of the Gastrointestinal Symptom Rating Scale in patients with gastroesophageal reflux disease. Qual Life Res. 1998;7:75–83.
• Turan N, Aştı TA, Kaya N. Reliability and validity of the Turkish version of the Gastrointestinal Symptom Rating Scale. Gastroenterology Nursing. 2017;40:47-55.
• Varma MG, Wang JY, Berian JR, Patterson TR, McCrea GL, Hart SL. The constipation severity instrument: a validated measure. Dis Colon Rectum. 2008;51:162-72.
• Kaya N, Turan N. Reliability and validity of constipation severity scale. Turkiye Klinikleri Journal of Medical Sciences. 2011;31:1491–501.
• Marquis P, De La Loge C, Dubois D, McDermott A, Chanssany O. Development and validation of the Patient Assessment of Constipation Quality of Life questionnaire. Scand J of Gastroenterol. 2005;40:540-51.
• Dedelı̇ Ö, Turan İ, Fadıloğlu Ç. Bor S. Konstipasyon yaşam kalitesi ölçeğinin geçerlilik ve güvenilirlik çalışması. MN Dahili Tıp Bilimleri Dergisi. 2007;2:36-43.
• Lacy BE, Patel NK. Rome criteria and a diagnostic approach to irritable bowel syndrome. J Clin Med. 2017;6:99.
• Eypasch E, Williams JI, Wood-Dauphinee S, Ure BM, Schmülling C, Neugebauer E, et al. Gastrointestinal Quality of Life Index: Development, validation and application of a new instrument. Br J Surg. 1995;82:216-22.
• Lee WJ, Lee MH, Yu PJ, Wei JH, Chong K, Chen SC, et al. Gastro-intestinal quality of life after metabolic surgery for the treatment of type 2 diabetes mellitus. Obes Surg. 2015;25:1371-9.
• Bintvihok W, Chaikittisilpa S, Panyakamlerd K, Jaisamrarn U, Taechakraichana N. Cut-off value of body fat in association with metabolic syndrome in Thai per-and postmenopausal women. Climacteric. 2013;16:393-7.
• Bebispro for Windows, Stuttgart, Germany; Turkish Version (Bebis 4), Istanbul 2004. Program Uses Data From Bundeslebensmittelschlüssel (BLS) 11.3 and USDA 15.
• Afshar S, Kelly SB, Seymour K, Woodcock S, Werner AD, Mathers JC. The effects of bariatric procedures on bowel habit. Obes Surg. 2016;26:2348-54.
• Menenakos E, Stamou KM, Albanopoulos K, Papailiou J, Theodorou D, Leandros E. Laparoscopic sleeve gastrectomy performed with intent to treat morbid obesity: A prospective single-center study of 261 patients with a median follow-up of 1 year. Obes Surg. 2010;20:276-82.
• Kvehaugen AS, Farup PG. Changes in gastrointestinal symptoms and food tolerance 6 months following weight loss surgery: Associations with dietary changes, weight loss and the surgical procedure. BMC Obes. 2018;5:29.
• Ostruszka P, Vávra P, Tulinský L, Ihnát P. Changes in bowel habits after laparoscopic sleeve gastrectomy. Wideochir Inne Tech Maloinwazyjne. 2020;15:469-77.
• Zhao Y, Yu YB, Intestinal microbiota and chronic constipation. SpringerPlus. 2016;5:1130.
• Dimidi E, Christodoulides S, Fragkos KC, Scott SM, Whelan K. The effect of probiotics on functional constipation in adults: A systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr. 2014;100:1075–84.
• Ciobârcă D, Cătoi AF, Copăescu C, Miere D, Crișan G. Bariatric Surgery in Obesity: Effects on Gut Microbiota and Micronutrient Status. Nutrients. 2020;12:235.
• Kommers MJ, Silva Rodrigues RA, Miyajima F, Zavala Zavala AA, Ultramari VRLM, Fett WCR, et al. Effects of Probiotic Use on Quality of Life and Physical Activity in Constipated Female University Students: A Randomized, Double-Blind Placebo-Controlled Study. J Altern Complement Med. 2019;25:1163-71.
• Wildt S, Munck LK, Vinter-Jensen L, Hanse BF, Nordgaard-Lassen I, Christensen S, et al. Probiotic treatment of collagenous colitis: a randomized, double-blind, placebo-controlled trial with Lactobacillus acidophilus and Bifidobacterium animalis subsp. Lactis. Inflamm Bowel Dis. 2006;12:395-401.
• Yu PJ, Tsou JJ, Lee WJ, Lee KT, Lee YC. Impairment of gastrointestinal quality of life in severely obese patients. World J Gastroenterol. 2014;20:7027–73.
• Ignat M, Vix M, Imad I, D'Urso A, Perretta S, Marescaux J, et al. Randomized trial of Roux-en-Y gastric bypass versus sleeve gastrectomy in achieving excess weight loss. Br J Surg. 2017;104:248-56.