Probiotics After Surgery - A Stronger Recovery – HealFast
probiotics example: fresh sauerkraut in a bowl on a rustic table

Probiotics After Surgery - A Stronger Recovery

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.

human 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.

What Are Probiotics And Why Do They Matter For Your Stomach’s Health?

Probiotics are tiny microorganisms that supply us with numerous health benefits when we have enough of them. Having a proper amount of these bacteria goes a long way in making sure we stay healthy.

Why Do We Need Probiotics

  • Keeping Balance: Probiotics stop growth of harmful bacteria.
  • Boosting Our Body's Defenses: Our bodies fight off sicknesses mostly from the gut. With the right amount of probiotics, fighting germs becomes much easier.
  • Help with Eating & Digestion: When you eat something, these little friends break everything down and ensure proper work of our digestive tract.
  • Easing Inflammation: Probiotics can calm inflammation down, which is great for speeding up healing, especially if there have been surgeries done before.

kefir with fruits and nuts on a wooden table

How Probiotics Help You Heal Faster After Surgery

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.

Immune Function Component Role in Immune System Impact of Probiotics
Antibody Production Helps identify and neutralize pathogens Probiotics increase the production of antibodies
Macrophages Engulf and digest cellular debris and pathogens Probiotics enhance macrophage activity
T-Lymphocytes Target and destroy infected cells Probiotics improve the function and response of T-lymphocytes
Immune System Balance Maintains overall immune homeostasis Probiotics support balanced immune responses and reduce infection risk

Giving Your Immunity A Boost

Generally, surgeries can make your body a bit worse at fighting infections, since the body is already so focused on recovery. But probiotics have the power to raise your shield by pushing up antibody production and improving the function of warriors like macrophages and T-lymphocytes in your immune system. Stronger immunity means fewer chances of a post-surgery infection that could slow down recovery.

Taming Overzealous Inflammation

While inflammation acts as proof that healing is taking place, if it goes overboard then it becomes harmful instead! Here again, probiotics step-in:

  • Bringing Down Inflammation: They reduce the production of substances called pro-inflammatory cytokines, thereby saving us from excessive inflammation hurting our progress.
  • Improving Healing Processes: These beneficial bacteria increase the amount of anti-inflammatory cytokines, which help with recuperation after surgical procedures.

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.

JAMA Surgery Published Research

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.

The Magic of Probiotics for Healing

If we want to see how probiotics help after surgeries, we need to grasp the science beneath it all. Scientific investigations have proven that our gut's good bacteria assist us in important ways - like boosting our immune system, managing weight and keeping our minds healthy. Moreover, there is a vast network in charge of sending messages from your gut to your brain and vice versa. This explains further why keeping our stomach happy matters:

Giving Your Immune System a Boost

Probiotics influence what doctors call GALT (short for Gut-Associated Lymphoid Tissue). What you should know about GALT is that it houses most of the cells defending our bodies against diseases. When these cells are stimulated by probiotics they become better fighters against infections and are more responsive towards inflammation attacks. And this aid is especially useful after surgery, when danger from infection is especially pronounced.

Mental Well-being While Recuperating From Surgery

The state of your gut is influencing how you feel emotionally, and this relationship between mental health and gut condition is referred to as the ‘gut-brain axis’. Recovering from a surgery can feel stressful, becoming a cause of worry. Probiotics are known helpers here since they boost levels of 'feel-good' chemicals like serotonin, playing a key role in mood control. Overall well-being becomes a part of the healing routine when probiotics come into play.

Picking the Right Probiotics

refrigerator with probiotic-rich foods

It's crucial to remember that not all probiotics are the same, and it’s key to pinpoint specific types and strains if you want to take full advantage of their positive impact. Here are some things you may want to keep in mind when selecting probiotics for a smooth recovery after surgery:

  • Bacterial Types: Different types of friendly bacteria offer varying health benefits. For healing post-surgery, scientists have found that certain types like Lactobacillus Acidophilus and Bifidobacterium Lactis can be extra helpful.
  • Number of Good Bacteria (CFU): CFU shows us how many alive bacteria there are in a particular probiotic product. Although more CFUs usually means better results, it's crucial we find a balance between strength and our body's ability to handle the supplement without any discomfort.
  • Form & Delivery: There are lots of ways to consume probiotics - from pills and capsules to liquids and powders. Some capsule-types come with an outer layer specifically designed to shield them from stomach acids so they make it safely down into our gut, maximizing their positive impact. 

Making Room for Probiotics Every Day

When using probiotics, it's helpful to have a steady routine. It’s good to take these supplements at roughly the same time every day – mealtimes often work well for this. 

The Practical How-To: Adding Good Bacteria in After-Operation Care

There are easy, practical ways to introduce 'good bacteria' - or probiotics - into your regimen after surgery. This can be done via what you eat and with extra supplements. Here is a step by step guide to make sure you get enough probiotics daily:

Plan A – Probiotics from the Pantry

  1. Yogurt – It comes loaded with active cultures of friendly bacteria like Lactobacillus and Bifidobacterium.
  2. Kefir – A great source of nutritional value, fermented with various types of good bacteria.
  3. Sauerkraut – Tasty pickled cabbage packed full of different kinds of gut-friendly lactic acid bacteria.
  4. Kimchi – A flavor-packed dish from Korea made using vegetables and spices that have been fermented, brimming over with useful microorganisms.

If eating these foods regularly is tough for you, don't despair! There's a plan B:

Plan B – Probiotic Supplements

For those who find it hard to consistently consume food rich in helpful bacteria colonies, there's an efficient alternative - getting a high quality probiotic supplement. Just make sure you select probiotics made for surgery recovery, which have a high CFU (Colony Forming Units) count and contain a variety of helpful strains. 

assorted probiotic supplements on a white background

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

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9818925/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2785020/
https://pubmed.ncbi.nlm.nih.gov/33753873/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469458/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10346906
 

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.

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