Dysbiosis and Gastrointestinal Surgery: Current Insights and Future Research

Abstract

Surgery of the gastrointestinal tract can result in deep changes among the gut commensals in terms of abundance, function and health consequences. Elective colorectal surgery can occur for neoplastic or inflammatory bowel disease; in these settings, microbiota imbalance is described as a preoperative condition, and it is linked to post-operative complications, as well. The study of bariatric patients led to several insights into the role of gut microbiota in obesity and after major surgical injuries. Preoperative dysbiosis and post-surgical microbiota reassessment are still poorly understood, and they could become a key part of preventing post-surgical complications. In the current review, we outline the most recent literature regarding agents and molecular pathways involved in pre- and post-operative dysbiosis in patients undergoing gastrointestinal surgery. Defining the standard method for microbiota assessment in these patients could set up the future approach and clinical practice.

The Effect of Perioperative Probiotics or Synbiotics on Postoperative Ileus in Patients Undergoing Abdominal Surgery: An Evidence-based Case Report

“…However, most of the evidence comes from animal studies, and the effects on humans are still being determined because the research is still limited. 7,13 Meanwhile, the RCT study conducted by Rodriguez-Padilla et al did not find a significant difference in the use of preoperative probiotics compared to placebo on the incidence of paralytic ileus (p=0.192). 14 There is still no recommended strains and dosage of perioperative probiotics or synbiotics for abdominal surgery patients.…”

“…Hence, the administration of probiotics or synbiotics could lower postoperative morbidity. 7 The cause of postoperative ileus has not been fully understood. It is known to involve the interaction of various factors.…”

“…According to various studies, synbiotics and probiotics can lower the risk of postoperative gastrointestinal infections and increase gastrointestinal motility, reducing the incidence of postoperative ileus. 6,7 Probiotics are live microorganisms that can benefit the host when consumed in adequate amounts. Synbiotics are a combination of probiotics and prebiotics, precisely live microorganisms and substrates that are selectively used by host microorganisms that can provide health benefits for the host.…”

Microbiota Phenotype Promotes Anastomotic Leakage in a Model of Rats with Ischemic Colon Resection

“…The gut microbiota has been proposed as a critical factor in colorectal surgery complications. It has been hypothesized as the “missing factor” that could explain little-understood complications of an anastomotic leak [ 44 ]. Bacterial diversity (alpha diversity) is believed to contribute to the stability of the microbiome.…”

Gut Microbiota in Non-Alcoholic Fatty Liver Disease Patients with Inflammatory Bowel Diseases: A Complex Interplay

“…DSS-induced colitis can promote the progression of inflammation and liver fibrosis by inducing microbiota dysbiosis, resulting in the triggering of an inflammatory response with the disruption of angiocrine signaling in non-parenchymal liver cells. On the other hand, IBD patients present with typical malnutrition, a condition closely linked to a vitamin deficiency, a factor involved in the development of liver pathologies [57].…”