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Gut microbiome, surgical complications and probiotics

2016; Hellenic Society of Gastroenterology; Linguagem: Inglês

10.20524/aog.2016.0086

1792-7463

George Stavrou,

Gastrointestinal motility and disorders

Th e trigger for infectious complications in patients following major abdominal operations is classically attributed to endogenous enteral bacterial translocation, due to the critical condition of the gut.Today, extensive gut microbiome analysis has enabled us to understand that almost all "evidence-based" surgical or medical intervention (antibiotics, bowel preparation, opioids, deprivation of nutrition), in addition to stress-released hormones, could aff ect the relative abundance and diversity of the enteral microbiome, allowing harmful bacteria to proliferate in the place of depressed benefi cial species.Furthermore, these bacteria, aft er tight sensing of host stress and its consequent humoral alterations, can and do switch their virulence accordingly, towards invasion of the host.Probiotics are the exogenously given, benefi cial clusters of live bacteria that, upon digestion, seem to succeed in partially restoring the distorted microbial diversity, thus reducing the infectious complications occurring in surgical and critically ill patients.Th is review presents the latest data on the interrelationship between the gut microbiome and the occurrence of complications aft er colon surgery, and the effi cacy of probiotics as therapeutic instruments for changing the bacterial imbalance.