Is your gut lacking this after gastric sleeve & bypass?

Improving gut health is an essential consideration after bariatric surgery.  

Studies have repeatedly shown the bacterial shift that occurs after gastric sleeve and bypass surgery. Some of these shifts are positive, while some are negative.

The fact that multiple studies are reporting the same or very similar results is always encouraging, even though this area of research is still young and growing.

For example, the Firmicutes and Bacteroidetes bacteria shift after gastric sleeve & gastric bypass surgery. Although both experience different shifts, the Firmicutes/Bacteroidetes ratio quickly changes. 

No matter what, prioritizing a healthy gut is important for both surgeries.

Firmicutes and Bacteroidetes are in the family of beneficial microbes. 

Let’s discuss the beneficial gut microbes and how their shifting may affect your health in detail.

Beneficial gut microbes

Let’s start by discussing what beneficial gut microbes are. These beneficial gut microbes are also known as good bacteria. 

In your gut, you have trillions of both good and bad microorganisms. A harmonious balance exists between these good and bad.

The absence of adequate beneficial microbes will cause you to suffer from health problems, guaranteed. Because beneficial gut bacteria play significant roles in your body.

Important Role of Beneficial Bacteria

You see, beneficial gut bacteria are responsible for several things:

1. Extracting nutrients and energy from the food we eat
2. Maintaining gut barrier function
3. Produce vitamins (B vitamins & Vitamin K)
4. Protect against colonization of potential pathogens
5. Responsible for maintaining the immune system
6. Supports metabolism

Moreover, these beneficial microbes sit on the top layer of mucus that lines your intestines. Where they’re ready to fight your microbial battles that occur every day!

Examples of Beneficial Bacteria

A few examples of beneficial bacteria include:

• Bacteroides fragilis
• Bifidobacterium
• Lactobacillus 
• Clostridium
• Enterobacter
• Enterococcus
• Escherichia

There are no prescription medications that can increase these beneficial bacteria at this time.  

However, it is possible to increase levels of healthy bacteria through a healthy diet, lifestyle changes, supplements, and probiotics.

So as you can see, all beneficial microbes are important to your overall health. But there are a couple of good microbes that dominate.

Two is the majority!

Your entire gut flora comprises several species of microorganisms, including bacteria, yeast, and viruses.  

The classification of bacteria is based on the phyla, classes, orders, families, genera, and species. 

In fact, two phyla represent 90% of your gut microbes. These include Firmicutes and Bacteroidetes. They are considered the two most important phyla in your gastrointestinal tract. 

The ratio between Firmicutes/Bacteroidetes (F/B ratio) has been associated with maintaining health. Changes in this ratio lead to disease.

For example, increases in the abundance of specific firmicutes lead to obesity, and an increase in the abundance of Bacteroides species leads to bowel inflammation.  

Firmicutes play a bigger role in metabolism. On the other hand, bacteroidetes play a significant role in your immune health. 

You might be questioning, Wouldn’t “more” beneficial bacteria be a good thing?

Actually, the goal of Firmicutes and Bacteroidetes is to maintain balance. Not more of one or less of the other. Just the Balance!

Firmicutes Facts

As we mentioned, Firmicutes plays a bigger role in your metabolism, but is also connected to other health issues.

What we understand so far about firmicutes, they…

• Extract more calories from the foods we consume
• Increase fat storage
• Impair insulin sensitivity
• Increase inflammation

So as you can see, having more firmicutes than bacteroidetes has a negative impact on your waistline. As well as your overall health.

But what causes this shift?

Potential causes of High F/B ratio

Understanding the “why” is always important! If you don’t change what’s causing it, you will likely be stuck with health problems. 

Some potential causes of high F/B ratio:

• Low stomach acid
• Inadequate enzymes causing maldigestion of food
• Low fiber, high refined carbohydrate diet
• Dysbiosis 

If you want to understand dysbiosis better, please visit this blog post titled “Part 3: Dysbiosis- Surprising causes of weight gain after WLS”.  

So as you can see, it’s important to have adequate beneficial bacteria. Including a balanced F/B ratio! 

You may be wondering, How can we know we have a disturbed or low balance of bacteria? Let’s learn!

How do you know if you are low in beneficial bacteria?

As we’ve discussed, all beneficial microbes are necessary for optimal health. Yet a couple has a very significant role.  

Firstly

If you are lacking overall beneficial bacteria, you would likely experience: 

1. Overgrowth of opportunistic bacteria. 
2. Vitamin and mineral deficiencies.
3. Increased autoimmunity, such as type 2 diabetes, thyroid disease, etc
4. Alterations in your metabolism are likely causing weight gain. Most likely in the mid-section.
5. Frequently get sick.
6. Digestive issues, such as constipation, diarrhea, gas & bloating.
7. Food intolerances, sensitivities, or allergies.
8. Joint pain
9. Skin issues, such as eczema, psoriasis, and acne.
10. Increased cravings, especially for sugar and carbs. 

Secondly

As we’ve noted, the significance of the F/B ratio represents 90% of gut microbes.  If you have more firmicutes than bacteroidetes, you would likely experience:

1. Weight gain, especially around your mid-section
2. Increased joint pain
3. An elevated level cravings, especially for sugar and carbs
4. Increasing appetite
5. Digestive issues

Although the all-encompassing beneficial microbes include Firmicutes and Bacteroidetes.  It doesn’t mean an imbalance in one creates an out-of-range result in the other. 

For example, you can have low levels of beneficial bacteria but a normal F/B ratio. Not to mention, different treatment modalities are necessary. 

Trying to improve your F/B ratio using the same treatment protocol may increase firmicutes more. More specifically, probiotic species and strains work differently.

How to deal with a lack of overall beneficial bacteria?

If you’re lacking in overall beneficial bacteria, using high-potency probiotics containing Lactobacillus, Bifidobacteria, or Bacillus species is helpful.

Yet, unfortunately, when Firmicutes is elevated, you should only consider using Bifidobacteria or Saccharomyces Boulardii primarily.  The Lactobacillus and Bacillus species can further elevate Firmicutes.

So, what are your best options to improve your overall beneficial bacteria and F/B ratio? It’s Testing!

Test don’t guess!

Your most accurate choice would be stool testing. One of the most comprehensive digestive evaluations available is the GI Map stool test. It’s an FDA-approved stool test.  

This test relies exclusively on quantitative polymerase chain reaction (qPCR) technology. It can detect parasites, bacteria, fungi, and more by targeting the specific DNA of the organisms tested.  

It can identify H. Pylori, parasites, worms, and harmful bacteria. It also exposes gut inflammation, low enzyme production, and fat malabsorption. Lastly, it’s a quantitative test that gives you an absolute number to help prioritize the immediate needs and concerns. 

Through this test, you will learn not only if you lack beneficial bacteria but also if you have an overgrowth of harmful bacteria. Additionally, you will be able to detect your F/B ratio and identify other causes of your digestion problems.

This provides you with the most personalized guidance and customized recommendations.  

In short, completing a stool test is the most accurate way to determine what’s driving your health issues.

Still, want to DIY? 

I get it. Testing sounds expensive! 

Now, please don’t misinterpret what I’m saying. I’m a fan of DIY when it comes to health. 

In reality, you are the only one living in your body. You know what you’re experiencing.  

But for some, you’ll spend more money “guessing” by trying different foods, supplements, and probiotics.

My best advice is if you’ve been experiencing these symptoms for quite some time, opting for testing might be your best option.

But, if you’re not quite ready or feel stool testing isn’t necessary yet, here are some strategies to consider. 

Improving beneficial gut bacteria

Here’s the great news! Improving your gut health is possible!  

• You can increase beneficial gut bacteria.
• Rebalance an overgrowth of opportunistic bacteria.
• Calm your inflammation. 
• Can correct enzyme production and fat malabsorption. 
• Restoring the F/B ratio is posible. 

Where do you begin?

If low levels of beneficial bacteria truly drive your symptoms. Then a great place to start is:

1. Increase vegetables and fibers.
2. Increase foods rich in polyphenols to promote the growth of probiotic microbes. These include Berries, cocoa powder, dark chocolate, hazelnuts, plums, soy flour, and sweet cherries. 
3. Remove sugar, refined carbohydrates, and grains. Whole grains are great, though! 
4. Be careful with artificial sweeteners. They alter gut bacteria! 
5. Add fermented foods if tolerated. If you don’t tolerate it, check out my posts on bacterial overgrowth and FODMAPs. 
6. Improve nervous system regulation with daily meditations. Especially before meals, to maximize digestion and optimization of enzyme production. Stress suppresses Lactobacillus, Bifidobacteria, and SIgA(First line defense against antigens and pathogens. 
7. Start taking high CFU multi-specie probiotics. It should contain Lactobacillus and Bifidobacterium strains. Our Ultimate gut restore probiotic is great for this.
8. Start taking Saccharomyces Boulardii. This is a healthy yeast that increases brush border activity and increases immune system regulation. Our Saccharomyces Boulardii is perfect!
9. Promote short-chain fatty acid production(SCFA). This stimulates bacterial growth & increases stool bulk. Adding beans, oats, and psyllium works great. 

These strategies work!

But, it will likely just take focused effort.  

Final words

A good eight weeks of diligence can start moving the dial for many. Restoring the complete balance will likely take 3-6 months. It just truly depends on the severity. 

Although I’m not a believer in perfection, it will require intentional efforts. Really intentional!  

Just taking a probiotic but still following a low-fiber diet will do very little.  

Taking a probiotic but still living a high-stress life will not provide lasting results. 

Start with adding one of these. Then add each one as you go. Once you start feeling better, it helps reinforce changes. Making it easier to continue. 

If you feel overwhelmed, reach out. I have coaching packages to help you stay the course and achieve true healing.