The findings support the effects of BAs on satiety , lipid and cholesterol metabolism , incretins and glucose homoeostasis , energy metabolism , gut microbiota and endoplasmic reticulum stress following bariatric surgery .
Many of these metabolic effects are modulated through the BA receptors FXR and TGR5 .
We also explore a possible link between BAs and carcinogenesis following bariatric surgery .
Conclusions : Overall there is good evidence to support the role of BAs in the metabolic effects of bariatric surgery through the above mechanisms .
BAs could serve as a novel therapeutic pharmacological target for the treatment of obesity and its associated co-morbidities
Background : Bariatric surgery is currently the most efficacious treatment for obesity and its associated metabolic co-morbidities , such as diabetes .
The metabolic improvements occur through both weight-dependent and weight-independent mechanisms .
Bile acids ( BAs ) have emerged as key signalling molecules that have a central role in modulating many of the physiological effects seen after bariatric surgery .
This systematic review assesses the evidence from both human and animal studies for the role of BAs in reducing the metabolic complications of obesity following bariatric surgery .
The role of bile after Roux-en-Y gastric bypass in promoting weight loss and improving glycaemic control.
Gastric bypass leads to the remission of  type 2 diabetes  independently of weight loss . Our hypothesis is that changes in bile flow due to the altered anatomy may partly explain the metabolic outcomes of the operation . We prospect ively studied 12 patients undergoing gastric bypass and six patients undergoing gastric b and ing over a 6-wk period . Plasma fibroblast growth factor (FGF)19 , stimulated by bile acid absorption in the terminal ileum , and plasma bile acids were measured . In canine and rodent models , we investigated changes in the gut hormone response after altered bile flow . FGF19 and total plasma bile acids levels increased after gastric bypass compared with no change after gastric b and ing . In the canine model , both food and bile , on their own , stimulated satiety gut hormone responses . However , when combined , the response was doubled . In rats , drainage of endogenous bile into the terminal ileum was associated with an enhanced satiety gut hormone response , reduced food intake , and lower body weight . In conclusion , after gastric bypass , bile flow is altered , leading to increased plasma bile acids , FGF19 , incretin . and satiety gut hormone concentrations . Elucidating the mechanism of action of gastric bypass surgery may lead to novel treatments for type 2 diabetes
The findings support the effects of BAs on satiety , lipid and cholesterol metabolism , incretins and glucose homoeostasis , energy metabolism , gut microbiota and endoplasmic reticulum stress following bariatric surgery .
Many of these metabolic effects are modulated through the BA receptors FXR and TGR5 .
We also explore a possible link between BAs and carcinogenesis following bariatric surgery .
Conclusions : Overall there is good evidence to support the role of BAs in the metabolic effects of bariatric surgery through the above mechanisms .
BAs could serve as a novel therapeutic pharmacological target for the treatment of obesity and its associated co-morbidities
Background : Bariatric surgery is currently the most efficacious treatment for obesity and its associated metabolic co-morbidities , such as diabetes .
The metabolic improvements occur through both weight-dependent and weight-independent mechanisms .
Bile acids ( BAs ) have emerged as key signalling molecules that have a central role in modulating many of the physiological effects seen after bariatric surgery .
This systematic review assesses the evidence from both human and animal studies for the role of BAs in reducing the metabolic complications of obesity following bariatric surgery .