The enhancement of the gut barrier function is important for the perioperative management of intra–abdominal infection or high risk surgery patients

• Published in: Journal of Japan Society for Surgical Infection Vol. 17; no. 2; pp. 82 - 88
• Main Authors: Matsui, Daisuke, Tajima, Hidehiro, Ohta, Tetsuo, Takamura, Hiroyuki, Nishijima, Koji, Miyashita, Tomoharu, Futagami, Fumio
• Format: Journal Article
• Language: Japanese
• Published: Japan Society for Surgical Infection 30.04.2020; 一般社団法人 日本外科感染症学会
• Subjects: グルタミン・BCAA療法; 周術期管理; 腸管粘膜防御機構; 腹腔内感染症
• ISSN: 1349-5755; 2434-0103
• DOI: 10.24679/gekakansen.17.2_82

The gut barrier plays an essential role in maintaining host homeostasis. The barrier regulates nutrient absorption as well as prevents the invasion of pathogenic bacteria in the host. It is composed of epithelial cells, tight junctions, and a mucus layer. Several factors, such as perioperative fasting, antimicrobial therapy and surgical invasion can affect this barrier. These factors have been shown to increase intestinal permeability, inflammation, and translocation of pathogenic bacteria. Bacterial Translocation into portal blood from the small and large intestine with reduced gut barrier function has influence to liver dysfunction. Therefore, enhancing the gut barrier function may play a central role of therapy because target organ is gut in perioperative period. We have devised the combined therapy with Glutamine/BCAA and synbiotics in the perioperative period for patients undergoing high risk surgery or causing intra–abdominal infections. We concluded that this bundle therapy which improving the gut environment during the perioperative period may prevent the perioperative surgical complication.