ABSTRACT
The microbiota or gut flora in the intestines contains billions of bacteria located throughout the large colon and small bowel. The phenotypic makeup of flora is highly diverse among individuals, influenced by genetic and environmental factors and previous exposures as early as childbirth. A possible modality to help maintain and repopulate a healthy gut flora is supplementation with prebiotics and probiotics. The use of probiotics and synbiotics in severe acute pancreatitis (AP) was initially controversial since the PROPATRIA trial raised major safety concerns surrounding their association with increased bowl ischemia and mortality. With increasing recognition of the role intestinal dysbiosis may play in development of various diseases, influencing and restoring the microbiota with prebiotics, probiotics, synbiotics, or even with FMT has gained interest. Enthusiasm for judicious use of these therapies must be tempered, however, by the fact that no single product is a panacea and specific therapies may only be appropriate for certain populations.
