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

Abstract

Background: Abdominal operations may lead to post-operative bowel dysfunction, while administration of probiotics, prebiotics and synbiotics may limit its manifestation. Τhe study aimed to assess the efficacy of probiotics, prebiotics and synbiotics in patients who undergone abdominal operation, in terms of bowel function post-operatively. Methods: PubMed, Scopus, Cochrane Central Register of Controlled Trials (Central), Embase, US Registry of clinical trials, and sources of grey literature were searched. The relative effect sizes were estimated, and we obtained the relative ranking of the interventions using cumulative ranking curves. Results: In total, 30 studies were included in the analysis. For the outcome of post-operative ileus, probiotics was superior to placebo/no intervention (relative risk, RR: 0.38; 95%CI: 0.14–0.98) with the highest SUCRA (surface under the cumulative ranking) value (92.1%). For time to first flatus, probiotics (MD: −0.47; 95%CI: −0.78 to −0.17) and synbiotics (MD: −0.53; 95%CI: −0.96 to −0.09) were superior to placebo/no intervention. For time to first defecation and for post-operative abdominal distension probiotics were superior to placebo/no intervention. For post-operative hospitalization days, synbiotics were superior to placebo/no intervention (MD: −3.07; 95%CI: −4.80 to −1.34). Conclusions: Administration of probiotics in patients who had undergone abdominal surgery reduced the prevalence of post-operative ileus, time to first flatus, time to first defecation, and prevalence of post-operative abdominal distension. Synbiotics reduce time to first flatus and post-operative hospitalization days.

Nutraceutical Combinational Therapy for Diarrhoea Control with Probiotic Beverages from Fermented Fruits, Vegetables and Cereals to Regain Lost Hydration, Nutrition and Gut Microbiota

“…Recent research reports probiotics can be used as supplements in the prevention and treatment of infectious diseases [ 42 ]. A network meta-analysis conducted by Ioannidis et al reported the efficacy of probiotics, prebiotics and synbiotics in patients who have undergone an abdominal operation, in terms of bowel function post-operatively [ 43 ].…”

Probiotics in Postoperative Pain Management

“…Today, many in vitro and in vivo studies have shown that probiotics exert potential suppressive effects on various infectious and inflammatory conditions, thus significantly shortening the inflammatory phase of the wound healing process [115][116][117]. At the same time, there are quite a lot of clinical studies referring to the reduction in postoperative bloating and the shortening of the time duration up to the first flatus, all indirectly indicating the shortening of the postoperative paralytic ileus [118][119][120]. Both the above [115][116][117][118][119][120] may not have a direct, suppressive effect on the pain originating from abdominal wall trauma, or from the distension of the gut wall, but there are many studies documenting the specific cytokine and other molecular changes which point in that direction.…”