Review of the management of diarrhea syndrome after a bariatric surgery

Abstract

Obesity is a prevalent health problem in our population. Bariatric surgery is the indicated treatment for severe cases. It is very effective (together with an adequate lifestyle modification) but it is also associated with frequent adverse events. One of the most frequent and disturbing adverse event is diarrhea. Diarrhea after bariatric surgery may be secondary to multiple causes and the physiopathogenic mechanisms may depend on the type of surgery performed. The most frequent diarrhea mechanisms are dumping syndrome, vagotomy, short bowel syndrome, carbohydrate malabsorption, protein malabsorption, alterations of the microbiota, Clostridium difficile infection, bacterial overgrowth, bile salt malabsorption, pancreatic insufficiency, endocrinological disorders, addictive disorders, and other digestive disorders not necessarily related to surgery.

Keywords: Bacterial overgrowth; Bariatric surgery; Bile acid malabsorption; Cirugía bariátrica; Diarrea; Diarrhea; Dumping syndrome; Insuficiencia pancreática; Intestino corto; Malabsorción; Malabsorción de sales biliares; Malabsorption; Pancreatic insufficiency; Short bowel; Sobrecrecimiento bacteriano; Síndrome de dumping.