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The quantitative and qualitative imbalance between these phyla, which occurs in SIBO, seems to be the key to the origin of various pathologies. More than 90% of the total microbial population in humans are dominated by four bacterial phyla: Firmicutes (40%), Bacteroidetes (19.7%), Actinobacteria (2.15%), and Proteobacteria (2.15%). Human gut microbiota is composed of a mosaic of microorganisms that vary between individuals, which represents personalized microbiological identity. The present study sought to identify the incidence of SIBO after RYGBP and laparoscopic OAGBP (LOAGBP), connection between SIBO and certain symptoms, comorbidities, and related liver pathology and correlation SIBO to low molecular weight heparin (LMWH) application to help prompt early evaluation of this condition in this patient population. The modification of normal gut anatomy after bariatric surgery may induce bacterial stasis and subsequently precipitate SIBO and nutritional deficiencies. Despite improving the overall quality of life of individuals, bariatric surgery is connected to the development of gastrointestinal symptoms, subsequently interfering with post-surgical quality of life and patient satisfaction. The only effective treatment considered for sustained long-term weight loss is bariatric surgery, with commonly performed procedures Roux-en-Y gastric bypass (RYGBP) and one-anastomosis gastric bypass (OAGBP). Microbiota pharmacological modulation seems to be a promising tool for a new therapeutic approach to NAFLD and in prevention of its complications. The spectrum of liver injury is broad, ranging from pure steatosis to non-alcoholic steatohepatitis, a more severe form of NAFLD, which can progress to cirrhosis, liver failure, and hepatocellular carcinoma (HCC). Because of the increasing prevalence of obesity, NAFLD has become one of the major causes of liver diseases. Several data suggest that SIBO could play a role in the pathophysiology of metabolic-associated fatty liver disease (MAFLD), formerly known as non-alcoholic fatty liver disease (NAFLD).

The recognition of SIBO is prudent, as the condition has been associated with altered small intestinal motility, fat malabsorption, vitamin deficiencies, reversible protein-losing enteropathy, and malnutrition. Small intestinal bacterial overgrowth (SIBO) is defined as a heterogeneous pathology characterised by an increased number and/or abnormal type of bacteria in the small intestine responsible for digestive symptoms such as bloating, abdominal pain, nausea, or diarrhoea. Obesity is considered as a complex and multifactorial disease, and one of the astonishing findings over the past decade has been the association and causative role played by gut bacteria in the pathophysiology of obesity and obesity-related complications and importantly, including a significant worsening of obesity-related diseases. The incidence of different diseases, such as cardiovascular disease, type 2 diabetes, and cancer, has been strongly associated with obesity, leading to a significant economic and social burden of pandemic magnitudes.

Obesity is a worldwide public health problem continuing to rise rapidly.
