Microbiota en el paciente quirúrgico del aparato digestivo: diagnóstico y manejo

Abstract

There is an intimate and two-way relationship between our microbiome and the genome. The normobiosis corresponds to the situation in which the commensal and symbiotic bacteria are in balance with the enteropathogenic bacteria. In normobiosis we benefit in terms of strengthening the intestinal barrier, immunological tolerance and the production of a huge number of molecules synthesized by the intestinal microbiota. The dysbiosis, where the enteropathogenic bacteria prevail over the symbiotic and commensal, is related to adverse conditions, such as inadequate diet, sedentary lifestyle, tobacco and alcohol consumption, physical and emotional stress, diseases, use of antibiotics and other medications. In dysbiosis, intestinal permeability increases, translocation of microorganisms and inappropriate molecules may occur and an inflammatory response is established whose intensity may depend on the type and intensity of the prevalence of the pathogenic bacteria. With this the benefit of normobiosis is lost. The composition of the intestinal microbiota may be altered in the surgical patient of the digestive system for reasons inherent to the patient, the surgical procedure and the microbiota itself. Interventions with prebiotics, probiotics and symbiotics may be useful in reducing postoperative morbidity. With the enormous development of knowledge in this area, the surgeon, knowing the alterations and the modulation of the microbiota and its metagenomics, will be able to greatly benefit his patients.