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Probiotics After Surgery, Effective and Safe?

Probiotics After Surgery, Effective and Safe?

Yogurt can be a good source but it’s hard to get the recommended amount of probiotics from yogurt alone. That’s why supplements are typically required.

Probiotics have long been recognized as part of a healthy diet. However, supplementation with the beneficial bacteria that reside in the digestive system and gut in humans; otherwise known as the intestinal flora, may also help you recover more quickly after surgery. Read on to find out what studies say about probiotics and surgery.

Originally thought to simply improve the microbial balance of the gut and inhibit harmful bacteria, probiotics are today being investigated for their overall positive influence on human health. Probiotics are increasingly seen as connected to alleviating chronic inflammatory disease of the intestine, pathogen-caused diarrhea, urogenital infections, and atopic diseases (“probiotic,” 2013).

Probiotics can be obtained by eating cultured and fermented foods, such as yogurt, sauerkraut, aged cheese, etc. You can also take probiotics in the form of a dietary supplement.

Probiotics, Post-Surgery

Bacterial infection is a frequent complication, post-surgery; especially in operations involving the gastrointestinal tract such as colon and gallbladder surgery. Research indicates that the friendly bacteria in these supplements can help break down food, which may be very useful since the efficiency of digestion is decreased after such operations.

Two studies on probiotics supplementation in people with ulcerative colitis who have had part or all of the colon removed  found that probiotics helped prevent inflammation. Used right after surgery the probiotics helped prevent the infection (pouchitis) from developing at all. The participants were given either a placebo or a mixture of various probiotics, including four strains of Lactobacilli , three strains of Bifidobacteria , and one strain of Streptococcus salivarius .

Despite the use of antibiotics, the incidence of postoperative infections can range from 10-30% in gastrointestinal surgery cases. Most of these infections have enteric origins (enteric means “pertaining to the intestines”). The trauma of surgery can adversely affect the gut microbial flora and cause dysfunction in the gut barrier function.

Battle The Harsh Side Effects of Antibiotics

Administration of antibiotics can cause imbalance in the microbial flora, as well as promote the growth of antibiotic-resistant bacterial strains. Use of probiotics can positively influence postoperative health by stabilizing the intestinal barrier, stimulating epithelial growth, revitalizing mucus secretion and motility, and enhancing overall immunity (Jeppsson, Bengt, et al., 2011, May 12).

One study, conducted at the Rand Institute, found evidence that probiotics can lower the risk of antibiotic-related diarrhea.

Faster Recovery

Another way probiotics might help reduce post-surgical infections is by helping patients recover quicker, thus shortening their hospital stays and the length of time required for antibiotics.

Shorter hospital stays are of great importance in two ways:

  1. shorter antibiotic regimens decrease the risk of emerging antimicrobial resistance; and
  2. reduce the risk of obtaining an infection from the hospital (Pitsouni, Eleni, et al., 2009).


Probiotics kill harmful bacteria in digestive system and clear the path for normal flora of the gut.

Other post-surgical conditions in which usage of probiotics after surgery have proven beneficial:

Liver Transplant

A study of 95 patients was conducted on the patients who recieved liver transplant. Results showed that only 13% of those patients who received probiotics developed infections. This study proved that probioctic plays an important role in preventing the patients with post-surgical infections.

In 2009, a review of clinical studies was published in “Langenbeck’s Archives of Surgery” found that the use of probiotic significantly reduces the cases of bacterial infection in patients with high-risk surgical procedures. The “European Journal of Clinical Pharmacology” in 2009 published that the postoperative use of probiotics decreases post-surgical death rates, shortens hospital stays and reduces the emergence of bacterial infections.

Gastric Bypass

A study was published in the “Journal of Gastrointestinal Surgery” in 2008. In this randomized controlled study, 44 patients of gastric bypass were kept on probiotic after surgery. Results showed that these patients had greater weight loss, improved bacterial overgrowth and vitamin B-12 levels as compared to the patients who did not recieve probiotic.


Pouchitis is a medical condition in which one portion of large intestine becomes inflamed following ileal pouch-anal anastomosis. In september 2008, the “Therapeutic Advances in Gastroenterology” published that usage of probiotics after this surgery remarkably decreases the risk of pouchitis further more it improves the risk of remission.

Are Probiotics Safe?

Probiotics are generally regulated as dietary supplements rather than as prescribed pharmaceuticals. As a result, there are no requirements to demonstrate safety, purity, or potency of these supplements. This can lead to significant inconsistencies between the stated and actual potency.

In the United States, dietary supplements do not have the review and approval requirements that other medicines do, and do not need approval by the Food and Drug Administration (FDA). In other places (i.e., Europe, Australia, and Japan), probiotics marketed for specific health use require regulatory review and approval for use by state-run health agencies (Boyle, .

How Much Should You Take?

To help the body heal, post-surgery, probiotics can be supplemented in doses ranging from 1 billion to 450 billion colony forming units (CFU). The extent to which a patient needs probiotic supplementation will depend on how healthy they were before the surgery took place, and how much antibiotics were administered to fight infections for the procedure. The average patient will benefit from a 50 billion CFU dose of probiotics (Schuler, Corey, 2012, September 12).

Which Type of Probiotics?

Since there are different strains which have different health benefits it’s often recommended to take all. This because we know they are beneficial to our health but more research has to be done on which strain is responsible for which health benefits. Most probiotic supplements do not contain all strains. Some for example have only bifidus or only acidophilus.  A high quality brand that is very well reviewed is Enzymatic Therapy. If you want to get all the strains I would recommend to buy either and or and IC.

In Summary

Probiotics, literally, “pro life, are increasingly being looked at as more than just a living flora in the digestive tract. After surgery, probiotics can be used to;

  1. promote healing,
  2. shorten hospital stays,
  3. restore balance to the digestive tract,
  4. and help stave-off postoperative infections.

They are known to stimulate the recovery process of many clinical conditions including diarrhea, lactose intolerance, colon cancer, cholesterol, blood pressure, immune function and infections, helicobacter pylori infections, inflammation, bacterial growth under stress, irritable bowel syndrome and colitis, necrotizing enterocolitis (NEC) as well as enhance vitamin production.

Since probiotics are not closely regulated by the FDA and different types of probiotics provide different therapeutic benefits, your medical professional should be consulted concerning what type and how much should be used. If taken as a supplement, a reputable brand should be selected with a known track-record of providing safe and reliable products.


Boyle, , Robins-Browne, , & Tang, . (2006, June). Probiotic use in clinical practice: what are the risks? Am J Clin Nutr, 83(6), 1256-1264. Retrieved from

Jeppsson, Bengt, Mangell, Peter, & Thorlacius, Henrik. (2011, May 12). Use of Probiotics as Prophylaxis for Postoperative Infections. Nutrients, 3, 604-612. doi:10.3390/nu3050604

Pitsouni, Eleni, Alexiou, Vangelis, Saridakis,Vasilis, Peppas, George, & Falagas, Matthew E. (2009). Does the use of probiotics/synbiotics prevent postoperative infections in patients undergoing abdominal surgery? A meta-analysis of randomized controlled trials. Eur J Clin Pharmacol, 65, 561–570. Doi:10.1007/s00228-009-0642-7

Probiotic. (n.d.). In Wikipedia. Retrieved May 27, 2013, from:

Schuler, Corey. (2012, September 12).Tips for Healing after Surgery part 4: Probiotics & Organ Function Retrieved from

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