Postoperative dysbiosis is common among patients who have undergone abdominal surgery. Dysbiosis has been linked with infection and diseases, such as autoimmune and autoinflammatory disorders. Probiotic use has become popular in the hospital setting for the prevention and treatment of surgical complications, such as surgical site infections, urinary tract infections, sepsis, and pneumonia. Probiotics are uniquely suited to support the body’s postoperative healing due to their abilities to block adhesion sites for pathogenic bacteria, degrade toxins, block toxin receptors, modulate immune responses, and produce inhibitory substances, such as hydrogen peroxide.

A randomized, double-blind, placebo-controlled trial studied the postoperative effects of probiotic use for patients with colorectal cancer. The treatment arm was given a 30 billion CFU mixture of six viable strains of Lactobacillus acidophilus, L. lactis, L. casei, Bifidobacterium longum, B. bifidum, and B. infantis twice daily for 6 months beginning 4 weeks postoperatively. Most of cases in this study did not experience surgical infection or require antibiotics. The study findings indicated a significant reduction in the level of pro-inflammatory cytokines (tumor necrosis factor-α, interleukin [IL]-17A, IL-17C, IL-22, IL-10, and IL-12). In addition, the study results also indicated the use of postoperative probiotics did not exacerbate diarrhea or include any safety concerns.

Another clinical trial assessed the effects of probiotics on patients with a history of recent abdominal surgery. A probiotic mixture was administered for 8 weeks, including L. plantarum, L. lactis, and L. delbrueckii. The study found statistically significant postoperative treatment reductions in abdominal pain and bloating, and significant improvements in stool form. No clinically relevant adverse events were reported, and the treatment was well-tolerated by all patients. The authors of this study did note the importance of choosing probiotic products containing strains that align with the targeted condition, in addition to the proper dose, source, and quality control of the manufacturer, along with the product’s shelf life.

 Although the studies described above focus on abdominal surgery, a review article pointed out the ways that probiotics could also be beneficial for other types of surgeries postoperatively. The study described that intestinal dysbiosis due to postoperative administration of opioids and antibiotics could be ameliorated or reduced with the administration of probiotics.

 Probiotic use as part of a postoperative protocol has been shown to help the following: reduce certain pro-inflammatory cytokines, support the prevention of surgical complications, such as infection and sepsis, and support the gastrointestinal microbial balance in the presence of antibiotics and opioids. Research has also suggested that probiotics can be well-tolerated after many types of surgeries and may be a safe option in support of the gut and overall health of patients postoperatively.

By Colleen Ambrose, ND, MAT