The role of bile acids and intestinal microbiota in metabolic transformations after gastric bypass surgery

Today, the positive impact of bariatric surgery on the course of type 2 diabetes mellitus has been studied in detail. At the same time, not only the effect of direct weight loss and the incretin theory, but also other mechanisms for normalizing glycemia are being actively discussed. Thus, special attention is paid to the metabolism of bile acids and their influence on various indicators of homeostasis, including carbohydrate metabolism. After bariatric interventions of the bypass type, the passage of bile through the gastrointestinal tract, as well as its interaction with food masses, changes significantly, which served as the basis for studying this phenomenon. The information accumulated to date indicates enormous changes occurring not only in the anatomy, but also in the biology of the gastrointestinal tract after bariatric bypass surgery. The composition of the intestinal microbiota and the composition of bile masses undergo significant changes. Most of the works available today suggest that these changes are the cause of a number of metabolic rearrangements, and directly affect carbohydrate metabolism. This issue is still under study and accumulation of the necessary information, but today it can be stated with confidence that the role of bile passage, bile acid circulation and restructuring of the intestinal microbiota in the regulation of carbohydrate metabolism and energy balance after bariatric bypass surgery is of extreme importance.