Surgery’s Destructive Impact on the Flora

Two days have passed and I have already noticed my flora had been disrupted. I predicted this going in, and I still feel terrible knowing there was nothing I could do to stop it. Rebuilding and nurturing my flora, only to give it the biggest test in recent memory.

The Incident

Two weekends ago, I was travelling by bike to a friend’s house. The trip was cut short when I was t-boned by an SUV. A guardian angel was looking over me, giving me the instincts to jump off my bike and barrel roll on top the vehicles hood. Stupidly, I wasn’t wearing a helmet and I was blessed to only sustain a broken collarbone.  Having it be a nasty break, there would be a chance of non-union of the bones.  Considering my active lifestyle, I wanted to take no chances of the nonunion and the possibility of having limited mobility of my right arm.  Surgery ended up being the only option. Not happy about going under the knife, precautions had to be made for my 10 billion buddies residing in my gut. They would be under attack by 3 flora killers: anesthesia, antibiotics, and opiates.

Anesthesia

Having little knowledge how anesthesia works, I thought it just meant going to sleep and not feeling pain. It doesn’t just put you to sleep, but paralyzes your entire body, including your digestive system. This is why motility of food leaving your body gets slowed and thus creating constipation following surgery. Once your digestive system awakens, the natural process should just flow. But what happens if there is a bad flora intact? Undigested foods will create a feast for bad bacteria and give them a feeding ground. Fasting the night before should help limit the risk of unintentionally creating SIBO, but the colon will have the bulk of the load. Knowing my flora was in good shape, I wasn’t too concerned about the anesthesia.  Combining the anesthesia with antibiotics, now we are in trouble.

Antibiotics

Knowing the destructive nature of antibiotics on our gut microbiome, I was fearful for my flora. I’ve got to look out for my 90%! Naturally I would ask the orthopedic surgeon if there was any way they wouldn’t be able to give me antibiotics. “Please don’t destroy my flora.” I pleaded, but knew there was no way around this one. Flora got put on high alert for the antibiotic attack. Hopefully the 2 grams of intravenous antibiotics didn’t have their way and completely turn my flora into a waste land. For the sake of my flora, hopefully this will be my only course of the use of antibiotics. Reinforcements would be needed post-surgery. Take a look at this article by Chris Kresser explaining how even one round of antibiotics can be lethal to our flora and may permanently alter it.

Opiates

Never having an invasive surgery before, I didn’t know what to expect following the operation. ‘Scripts would be written but I didn’t intend on filling them. I mean comon, I didn’t need any pain medication for the initial break and the days that followed, how much pain can a little incision cause? Apparently enough to make me go delusional. So much for taking the natural route, I had to rely on the pharmaceuticals. Fearful of their addictive properties, I didn’t want to fall victim to them, but the pain had to be controlled before I passed out.

Pharmaceuticals have their place, but shouldn’t be taken unless you absolutely have to. Opiates aren’t only addictive, but they disrupt the flora. If the anesthesia wasn’t enough, taking opiates also slows the motility of your bowels. But that should be the least of your concerns when taking opiates.

The effects of morphine and a normal strain in our gut flora were examined in mice. While examining the mice, those who had morphine and the micrbiotic strain, P. aeruginosa, died, while those with either or neither survived. Taken from the Science Life publication from the University of Chicago,

                “Activated by morphine, P. aeruginosa suppressed the natural production of mucus in the intestine, disrupted the epithelial cells that line the gut, and provoked the immune system to release various immune factors. In morphine-treated mice, the bacteria also released a protein called PA-IL and exhibited “clumping” behavior, signs that they had changed in personality from pacifists to aggressors.”

Granted we aren’t mice, but this type of reaction with opiates and our microbiome certainly raises major concern. Our flora, particularly the P. aeruginosa strain, doesn’t react well with morphine. Who knows which other strains/opiates create a toxic mix for our bodies.

 

How to Keep the Flora Intact

Knowing these 3 major factors would be playing a major role during and following surgery, I made sure I was prepared to fight for my flora. First step was to give myself all the best bacteria and yeasts I needed.

Probiotics

The day before surgery I loaded up on my natural probiotic fermentation. Kimchi, sauerkraut, pickled eggs, kefir, and kombucha filled mason jars were scattered about my apartment awaiting my return from the hospital.

Food based probiotics wouldn’t be enough, that’s why I re-upped the dosage of my favorite probiotics. Added to the crew was HealthForce probiotics.

Gut Soother

My digestive tract would be under immense stress following surgery considering the immune response of being cut open and operated on. To help alleviate an inflamed, overworked gut, bone broth would be simmering in my newly bought crock pot. The soothing effects of bone broth would not only help calm my digestive tract, but also give me the minerals and vitamins needed to help heal my broken bone even faster!

Prebiotic Foods

Between onions, garlic, and resistant starch, I have administered enough prebiotics to help my probiotic recon team the best possible chance to repopulate my flora.

With my aggressive approach in restoring the flora, I should have no ill side effects of a compromised gut. Not giving the pathogens a chance to take residence in my gut was my biggest concern, and hopefully I can report back within a couple of weeks that my flora has been restored and my collarbone is rock solid.