Welcome back to another post in the HealFast Health and Wellness Series. Today's post comes from a conversation with a patient of mine. She wanted to know how probiotics aid surgery and injury recovery and what probiotics were the best choice for your health.

Probiotics are living bacteria and yeasts that are beneficial to your body.

Bacteria are everywhere, and we’ve made great precautions to reduce our interactions with these public health enemies across all walks of life. After all, bacteria cause disease, infections, and in someone with medical or post-surgery problems, can be fatal.

However, in your own body, there are more bacterial cells than even your own cells. Called the human microbiome, it is a highly complex battlefield, with constant struggles between the bad and so-called “good” bacteria. Before you worry, remember this daily struggle is part of a normal healthy microbiome.

“Bad bacteria” often become an issue during physiological stress

When we get injured or undergo surgery, this homeostasis (i.e., the tendency of a relatively stable equilibrium between interdependent elements) is often undermined.

Physiological stress can take on many forms from the minor - such as a small injury to the severe - such as invasive surgery or systemic disease. In my line of work, a majority of patients undergoing surgical operations receive prophylactic antibiotics, with the aim of reducing surgical infections.

Unfortunately, antibiotics, like the name implies are “anti” “bio”, and thus tend to kill the biome inhabitants rather indiscriminately. Yes, they do prevent surgical infections, but thus also offset the homeostasis (i.e. balance) of your natural microbiome.

How do probiotics help after surgery, injury, or sickness?

Today, extensive gut microbiome analysis has enabled us to understand how almost all surgical or medical interventions (antibiotics, bowel preparation, opioids, deprivation of nutrition), in addition to stress-released hormones, can harm the microbiome and shift the equilibrium.

This allows the harmful bacteria to proliferate in the place of depressed beneficial species. Meaning, when the microbiome is hit, the good bacteria that were keeping the bad bacteria in check, might become fewer in number and let the bad bacteria freely proliferate - potentially leading to complications. Furthermore, these bad bacteria can sense the host’s stress and physiologic changes, which can then switch their virulence accordingly, towards invasion. Bacteria are incredibly receptive to their environment!

So what does this all mean for Probiotics? Probiotics are the exogenously given, beneficial clusters of live bacteria, that can restore the distorted microbial balance. Thus, reducing the infectious complications occurring in surgical and or ill patients.

Why is maintaining the balance between good and bad “gut” bacteria so important?

In the field of gastrointestinal surgery, it has been shown that probiotics may be effective in restoring gut microbiota diversity, enhancing immunological response, reducing the systemic inflammatory response, and improving patients’ quality of life. Moreover, as a consequence of all the above, they appear to work positively in reducing the total length of stay in the hospital, the number of days of ventilator support required and of days in intensive care, as well as overall infectious complications. [1-6]

For example, in one paper published by Liu et al [7]; researchers analyzed the feces of patients undergoing colorectal surgery and found a reduction in microbial diversity of the “good” bacteria, including Bifidobacteria and Lactobacilli.

In contrast, the numbers of Enterobacteriaceae, Pseudomonas, and Candida, typically known to be harmful, showed a significant increase, which in turn was well correlated with the higher rate of infectious complications, 46% versus 14%, in probiotics-treated patients.

These studies translate well into other types of surgical interventions as well. In a recently conducted systematic review, the mean incidence of surgical site infection was 11.1%. Those treated with probiotics had 6.8% infection rate, representing a 37% reduction. This study also underlined the potential benefit in relation to urinary tract infections and composite infections, as well as the non-occurrence of serious adverse events. [8].

Ultimately, issues with antibiotic usage harming the microbiome and lack of probiotics to support healthy gut fauna can be attributed to many post-surgery complications. The below image shows the little known, but very typical surgery profile many patients experience throughout the US.

There is definitive proof that a healthy microbiome helps lead to a healthier recovery and patient overall. However, some strains are certainly better than others!

Because of the complexity of the individual gut microbiome, it is now common knowledge that probiotics are not a one-species-fits-all approach. Some studies showed no effect utilizing certain preparations of strains, while others found dramatic effects with other preparations.

While knowing which probiotic is best to use in each situation can be tricky, we have done some of the legwork for you and have discovered a very comprehensive probiotic review [9] for general usage. We found this guide to be very thorough and worthy of aiding your probiotic purchasing decisions for general probiotic uses.

However, if you are in need of injury or surgery recovery or are expecting an operation, you can rest easy! At HealFast, we’ve formulated the most evidence-based species into our Surgical and Injury Recovery Formula. All of our 7 strains of high-quality probiotics are active and alive after the manufacturing process and the copious amount of over 11 Billion Colony Forming Units (CFU’s), among other recovery ingredients, will help put a patient’s microbiome back in balance fast. If you have more specific nutritional needs, we always recommend that you speak with your nutritionist or primary care physician.

We hope you have enjoyed this probiotic post and have come to appreciate how important a strong microbiome can be for surgery and injury recovery. For more HealFast posts, check out our blog and be sure to follow us on Facebook and Twitter! As always be safe, stay informed, and be healthy!

Citations:

1. Kotzampassi K, Stavrou G, Damoraki G, et al. A four-probiotics regimen reduces postoperative complications after colorectal surgery: a randomized, double-blind, placebo-controlled study. World J Surg. 2015;39:2776–2783. [PubMed]

2. Zhang JW, Du P, Gao J, Yang BR, Fang WJ, Ying CM. Preoperative probiotics decrease postoperative infectious complications of colorectal cancer. Am J Med Sci. 2012;343:199–205. [PubMed]

3. Kotzampassi K, Eleftheriadis E Synbiotics in trauma: of proven benefit or a new fad. Intensive Care Units: Stress, Procedures, and Mortality Rates. Nova Science Publishers; 2011. pp. 149–158.

4. Stavrou G, Giamarellos-Bourboulis EJ, Kotzampassi K. The role of probiotics in the prevention of severe infections following abdominal surgery. Int J Antimicrob Agents. 2015;46(Suppl 1): S2–S4.[PubMed]

5. Mangell P, Thorlacius H, Syk I, et al. Lactobacillus Plantarum 299v does not reduce enteric bacteria or bacterial translocation in patients undergoing colon resection. Dig Dis Sci. 2012;57:1915–1924. [PubMed]

6. He D, Wang HY, Feng JY, Zhang MM, Zhou Y, Wu XT. Use of pro-/synbiotics as prophylaxis in patients undergoing colorectal resection for cancer: a meta-analysis of randomized controlled trials. Clin Res Hepatol Gastroenterol. 2013;37:406–415. [PubMed]

7. Liu Z, Qin H, Yang Z, et al. Randomised clinical trial: the effects of perioperative probiotic treatment on barrier function and post-operative infectious complications in colorectal cancer surgery - a double-blind study. Aliment Pharmacol Ther. 2011;33:50–63. [PubMed]

8. Lytvyn L, Quach K, Banfield L, Johnston BC, Mertz D. Probiotics, and synbiotics for the prevention of postoperative infections following abdominal surgery: a systematic review and meta-analysis of randomized controlled trials. J Hosp Infect. 2016;92:130–139. [PubMed]

9. Reviews.com. (2017). Best Probiotic Supplement Reviews of 2017 | Reviews.com. [online] Available at: https://www.reviews.com/probiotic-supplement/ [Accessed 29 Nov. 2017.

10. Stavrou, George, and Katerina Kotzampassi. “Gut Microbiome, Surgical Complications, and Probiotics.” Annals of Gastroenterology : Quarterly Publication of the Hellenic Society of Gastroenterology 30.1 (2017): 45–53. PMC. Web. 29 Nov. 2017.

11. Naturopathic, Y. (2017). What You Need to Know about Probiotics | Yaletown Naturopathic Clinic. [online] Yaletownnaturopathic.com. Available at: http://yaletownnaturopathic.com/what-you-need-to-know-about-probiotics/.

12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5198246/

13. https://www.reviews.com/probiotic-supplement/

14. Yaletown Naturopathic Clinic

General Disclaimer:

All information here is for educational purposes only and is not meant to cure, heal, diagnose nor treat. This information must not be used as a replacement for medical advice, nor can the writer take any responsibility for anyone using the information instead of consulting a healthcare professional. All serious disease needs a physician.