Probiotics in the Management of Surgery- Induced Diarrhea: Efficacy and Clinical Applications


Authors : Dr. P. Dhivyaprasath; Gayathri R ; Poovitha M ; Rabiyath Riswana M ; Sabithra P ; Susitha R

Volume/Issue : Volume 9 - 2024, Issue 11 - November

Google Scholar : https://tinyurl.com/mr457wtt

Scribd : https://tinyurl.com/myeuzzy9

DOI : https://doi.org/10.38124/ijisrt/IJISRT24NOV1132

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Abstract : Surgery-induced diarrhea (SID) is a frequent consequence of gastrointestinal procedures that is frequently brought on by disruptions to the microbiota, modifications to gut permeability, and changes in gut motility. It may cause severe morbidity, hindered healing, prolonged hospital stays, and higher medical expenses. Probiotics are live bacteria that, when given in sufficient quantities, offer health advantages. As a result, they have gained attention as a possible treatment strategy to lessen SID. Probiotics may reduce SID through a number of methods, including altered gut microbiome, improved mucosal barrier function, and pathogen suppression. In numerous clinical trials, probiotics like Lactobacillus, Bifidobacterium, and Saccharomyces boulardii have shown encouraging outcomes in lowering the frequency, length, and severity of postoperative diarrhea. Probiotics have also been linked to decrease inflammatory responses and enhanced immunological function, both of which are crucial in the post-surgical context. However, a number of variables, like the particular strains utilized, the dosage, the length of time of administration, and the patient's initial state of health and microbiome composition, affect how well probiotics work to manage SID. Even though the available data points to a positive safety profile for probiotics, especially in patients who are immunocompetent, more extensive randomized controlled trials are required to create standard recommendations for their application in clinical practice. This review examines the effectiveness of probiotics and their clinical uses in the treatment of Surgery induced diarrhea.

Keywords : Probiotics, Surgery, Diarrhea, Gut- Microbiome.

References :

  1. Khalighi A, Behdani R, Kouhestani S. Probiotics: A Comprehensive Review of Their Classification, Mode of Action and Role in Human Nutrition. Probiotics and Prebiotics in Human Nutrition and Health [Internet]. 2016 Jul 13
  2. Morowitz MJ, Babrowski T, Carlisle EM, Olivas A, Romanowski KS, Seal JB, et al. The Human Microbiome and Surgical Disease. Annals of Surgery. 2011 Jun; 253(6):1094–101.
  3. Lederer AK, Pisarski P, Kousoulas L, Fichtner-Feigl S, and Hess C, Huber R. Postoperative changes of the microbiome: are surgical complications related to the gut flora? A systematic review. BMC Surgery. 2017 Dec; 17(1).
  4. Collinson S, Deans A, Padua-Zamora A, Gregorio GV, Li C, Dans LF, et al. Probiotics for treating acute infectious diarrhoea. Cochrane Database of Systematic Reviews. 2020 Dec 8;
  5. Southern WN, Rahmani R, Aroniadis O, Khorshidi I, Thanjan A, Ibrahim C, et al. Post-Surgical Clostridium difficile-Associated Diarrhea. Surgery [Internet]. 2010 Jul 1; 148(1):24–30.
  6. Ohta H, Miyake T, Ueki T, Kojima M, Kawasaki M, Tatsuta T, et al. Predictors and clinical impact of postoperative diarrhea after colorectal cancer surgery: a prospective, multicenter, observational study (SHISA-1602). International Journal of Colorectal Disease. 2022 Jan 26; 37(3):657–64.
  7. Doron, S.; Gorbach, S.L. Probiotics: Their role in the treatment and prevention of disease. Expert Rev. Anti-Infect. Ther. 2006, 4, 261–275.
  8. Lee, Y.-J.; Yu, W.-K.; Heo, T.-R. Identification and screening for antimicrobial activity against Clostridium difficile of Bifidobacterium and Lactobacillus species isolated from healthy infant faeces. Int. J. Antimicrob. Agents 2003, 21, 340–346.
  9.   Gibson, G.R.; Hutkins, R.; Sanders, M.E.; Prescott, S.L.; Reimer, R.A.; Salminen, S.J.; Scott, K.; Stanton, C.; Swanson, K.S.; Cani, P.D.; et al. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nat. Rev. Gastroenterol. Hepatol. 2017, 14, 491–502
  10. Collado, M.C.; Gueimonde, M.; Sanz, Y.; Salminen, S. Adhesion Properties and Competitive Pathogen Exclusion Ability of Bifidobacteria with Acquired Acid Resistance. J. Food Prot. 2006, 69, 1675–1679.
  11. Brito, M.B.; Diaz, J.P.; Muñoz-Quezada, S.; Llorente, C.G.; Gil, A. Probiotic Mechanisms of Action. Ann. Nutr. Metab. 2012, 61, 160–174.
  12. Schmitz H, Barmeyer C, Fromm M, et al. Altered tight junction structure contributes to the impaired epithelial barrier function in ulcerative colitis. Gastroenterology. 1999;116:301–309
  13. Hilsden RJ, Meddings JB, Sutherland LR. Intestinal permeability changes in response to acetylsalicylic acid in relatives of patients with Crohn’s disease. Gastroenterology. 1996; 110:1395–1403.
  14. Yan F, Polk DB. Probiotics as functional food in the treatment of diarrhea. Current Opinion in Clinical Nutrition & Metabolic Care. 2006 Nov; 9(6):717–21.
  15. Mack DR, Ahrne S, Hyde L, Wei S, Hollingsworth MA (2003) Extracellular MUC3 mucin secretion follows adherence of Lactobacillus strains to intestinal epithelial cells in vitro. Gut 52: 827-833.
  16. Caballero-Franco C, Keller K, De Simone C, Chadee K. The VSL#3 probiotic formula induces mucin gene expression and secretion in colonic epithelial cells. American Journal of Physiology-Gastrointestinal and Liver Physiology. 2007 Jan; 292(1):G315–22
  17. Guandalini S. Probiotics for prevention and treatment of diarrhea. Journal of clinical gastroenterology. 2011 Nov 1; 45: S149-53.
  18. Park IJ. Effect of Probiotics/Synbiotics on Postoperative Outcomes in Patients Undergoing Abdominal Surgery. Annals of Clinical Nutrition and Metabolism. 2022 Jun 1; 14(1):10-9.
  19. Matzaras R, Anagnostou N, Nikopoulou A, Tsiakas I, Christaki E. The Role of Probiotics in Inflammation Associated with Major Surgery: A Narrative Review. Nutrients. 2023 Mar 8; 15(6):1331.
  20. Gueimonde M, Ouwehand AC, Salminen S. Safety of probiotics. Scandinavian journal of nutrition. 2004 Jan 1; 48(1):42-8.
  21. Desborough, J. The stress response to trauma and surgery. Br. J. Anish. 2000, 85, 109–117.
  22. Kimoto, H.; Mizumachi, K.; Okamoto, T.; Korimako, J.-I. New Lactococcus Strain with Immunomodulatory Activity: Enhancement of Th1-Type Immune Response. Microbiol. Imanol. 2004, 48, 75–82
  23. Hessle, C.; Andersson, B.; Wold, A.E. Gram-Positive Bacteria Are Potent Inducers of Monocyte Interleukin-12 (IL-12) while Gram-Negative Bacteria Preferentially Stimulate IL-10 Production. Infect. Immun. 2000, 68, 3581–3586.
  24. Goodman, C.; Keating, G.; Georgousopoulou, E.; Hespe, C.; Levett, K. Probiotics for the prevention of antibiotic-associated diarrhoea: A systematic review and meta-analysis. BMJ Open 2021, 11, e043054.
  25. Snydman DR. The safety of probiotics. Clinical infectious diseases. 2008 Feb 1; 46(Supplement_2):S104-11.
  26. Cannon JP, Lee TA, Bolanos JT, Danziger LH. Pathogenic relevance of Lactobacillus: a retrospective review of over 200 cases. Eur J Clin Microbiol Infect Dis 2005; 24:31–40
  27. Perapoch J, Planes AM, Querol A, et al. Fungemia with Saccharomyces cerevisiae in two newborns, only one of whom had been treated with ultra-levura. Eur J Clin Microbiol Infect Dis 2000; 19:468–70.
  28. Ioannidis O, Chatzakis C, Tirta M, et al. The Efficacy of Probiotics, Prebiotics, and Synbiotics in Patients Who Have Undergone Abdominal Operation, in Terms of Bowel Function Post-Operatively: A Network Meta-Analysis. J Clin Med. 2023; 12(12):4150. Published 2023 Jun 20. doi:10.3390/jcm12124150
  29. Trone K, Rahman S, Green CH, Venegas C, Martindale R, Stroud A. Synbiotics and surgery: can prebiotics and probiotics affect inflammatory surgical outcomes? Current Nutrition Reports. 2023 Jun; 12(2):238-46.
  30. Salminen MK, Rautelin H, Tynkkynen S, et al. Lactobacillus bacter-emia, species identification, and antimicrobial susceptibility of 85 blood isolates. Clin Infect Dis 2006; 42:e35–44
  31. Swenson JM, Facklam RR, Thornsberry C. Antimicrobial susceptibility of vancomycin-resistant Leuconostoc, Pediococcus, and Lacto-bacillus species. Antimicrob Agents Chemother 1990; 34:543–9.
  32. Sanders ME, Akkermans LM, Haller D, Hammerman C, Heimbach JT, Hörmannsperger G, Huys G. Safety assessment of probiotics for human use. Gut microbes. 2010 May 1; 1(3):164-85.
  33. Von Wright A. Regulating the safety of probiotics—the European approach. Curr Pharm Des 2005; 11:17-23.
  34. Wassenaar TM, Klein G. Safety aspects and implications of regulation of probiotic bacteria in food and food supplements. J Food Prot 2008; 71:1734-41

Surgery-induced diarrhea (SID) is a frequent consequence of gastrointestinal procedures that is frequently brought on by disruptions to the microbiota, modifications to gut permeability, and changes in gut motility. It may cause severe morbidity, hindered healing, prolonged hospital stays, and higher medical expenses. Probiotics are live bacteria that, when given in sufficient quantities, offer health advantages. As a result, they have gained attention as a possible treatment strategy to lessen SID. Probiotics may reduce SID through a number of methods, including altered gut microbiome, improved mucosal barrier function, and pathogen suppression. In numerous clinical trials, probiotics like Lactobacillus, Bifidobacterium, and Saccharomyces boulardii have shown encouraging outcomes in lowering the frequency, length, and severity of postoperative diarrhea. Probiotics have also been linked to decrease inflammatory responses and enhanced immunological function, both of which are crucial in the post-surgical context. However, a number of variables, like the particular strains utilized, the dosage, the length of time of administration, and the patient's initial state of health and microbiome composition, affect how well probiotics work to manage SID. Even though the available data points to a positive safety profile for probiotics, especially in patients who are immunocompetent, more extensive randomized controlled trials are required to create standard recommendations for their application in clinical practice. This review examines the effectiveness of probiotics and their clinical uses in the treatment of Surgery induced diarrhea.

Keywords : Probiotics, Surgery, Diarrhea, Gut- Microbiome.

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