Can Probiotics Improve the Gut Flora and Reduce Complications after Surgery?

probiotics

In a recent study, researchers investigate whether surgical complications can be reduced by using probiotics to improve the gut flora.

We have long established how the “good bacteria” in our intestines maintain the balance against potentially disease-causing bacteria residing in our bowels. The presence of good bacteria in the gut environment helps reduce inflammation and aids digestion. In fact, probiotic therapy is now an adjunct in the treatment of chronic conditions of the bowel like ulcerative colitis or Crohn’s disease.

After bowel surgery, patients have to endure the return of normal bowel function, which can last for a few days. Patients may also have abdominal cramping and bouts of diarrhea after procedures. More serious complications can also occur when there is spillage, particularly in the areas where the segments were joined during the procedure. Anastomotic leakage may occur, in which the resident bacteria usually living within the bowel escapes into the abdominal cavity where they can cause severe and even life-threatening infections.

Since good bacteria in the gut environment can have protective effects, researchers wanted to know if this mechanism could be extended to minimize or delay surgical complications. Scientists from the University of Frieburg in Germany conducted a systematic review of all clinical studies on post-operative complications from gastro-intestinal surgery in relation to the gut microbiome. The researchers found 10 relevant studies from across the globe where gut flora studies were also included during and after surgery, as well as the inclusion of probiotic treatment in the regimen, by giving the patient probiotics prior to surgery and upon resumption of bowel function. The results were correlated with the incidence of infections and the succeeding post-operative courses and were recently published in the journal BMC Surgery.

The studies indicate that surgical procedures lead to a change in the gut environment, with an increase of the pathogenic or disease-causing bacteria.  More significantly, patients with a healthier gut profile, or who were given probiotics, reported less infectious complications. Patients also noted faster recovery of bowel movement and a decrease in the common post-operative complaints of cramping and diarrhea.

There remains, however, a high degree of uncertainty as the majority of the studies were not conclusive. Further research is needed to confirm these results. The results from these studies point to the potential benefits of integrating probiotics into the surgical regimen, whether as part of the diet prior to or after the procedure. The promise of fewer complications and a faster recovery from simple probiotic supplementation should indeed encourage further research on this possibility.

Written by Jay Martin, M.D.

Reference: Lederer, et al. “Post-operative changes of the microbiome:  are surgical complications related to gut flora?  A systematic review.”  BMC Surgery (2017) 17:125. DOI:  10.1186/s 12893-017-0325-8.

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