Papel de los prebióticos y los probióticos en la funcionalidad de la microbiota del paciente con nutrición enteral

Set of resident microorganisms in our body that are responsible for the absorption of nutrients and the maintenance of health is named microbiota. The microbiota´s role is protective, trophic and metabolic. Different groups of microbiota intestinal name enterotypes, each one of them are in relation to specific dietary habits. The absence of enteral stimulation affects both epithelial and GALT and the development of the microbiota. This situation modifies the immune system´s interaction, with a less competitive exclusion of more pathogenic bacteria, which can promote infections. These changes are likely reversible when supplementation with enteral nutrition is used. Dietary fibre and probiotics, to be fermented by colonic microbiota produce gases and short-chain fatty acids causing an acid pH in the large intestine which hinders the growth of pathogenic microorganisms. The administration of probiotic with enteral nutrition in critically ill patients was associated with lower rates of infection with no effect on mortality, average stay, or diarrhea. Also proposed as a strategy to reduce infectious complications in elective surgery and to reduce the time of tolerance of enteral feeding in preterm or low birth weight. In acute pancreatitis, it has been suggested a possible role of probiotics to restore intestinal integrity, but more safety studies are needed. There are isolated cases of bacteremia, sepsis or endocarditis usually in immunocompromised patients. Yet the benefits appear to be greater than the risks.