The Role of the Use of Probiotics and Enema in Reducing the Septic Complications of Experimental Acute Pancreatitis in Rats

The purpose of this study was to investigate the effects of enema, probiotic agent Saccharomyces boulardii, and these two used together on the bacterial translocation, the histopathologic scores of pancreatitis, TNF-alpha serum levels, and the tissue expression of TNF-alpha in pancreatic tissue in Acute PancreatitisSham laparotomy was made to the rats in one of the 5 groups consisting of 8 animals each (Group 1). Acute pancreatitis was induced in the other 4 groups by laparotomy, biliopancreatic ductal cannulation and infusion of 3,5 % taurocholate into the biliopancreatic duct. No medications were given to the control group (Group 2). The third group was treated with enemas at the 6th and 24th hours after the induction of acute pancreatitis. The fourth group received probiotic agent S. boulardii via gastric cannulation at the 6th and 24th hours after the induction of acute pancreatitis. The fifth group was treated both with enema and probiotics at the 6th and 24th hours after the induction of acute pancreatitis. The animals were sacrificed at the 48th hour after the induction of acute pancreatitis and tissue samples were harvested for tissue culure, histopathologic examination of pancreatic tissues and the definition of TNF-alpha levels in pancreatic tissue. Blood samples were obtained for blood culture and the definition of serum amilase and TNF-alpha levelsAmilase levels were significantly high in all the pancreatitis groups when compared to the sham group (p<0,05). In the enema group there were significantly more rats with bacterial proliferation in mesenteric lymph nodes (p<0,05). In the probiotic group and probiotic+enema group there were no spleen or duodenum tissues with bacterial proliferation and this was significant when compared to the other groups (p<0,05). Tissue expression of TNF-alpha in pancreatic tissue was significantly high in the control group when compared to all the other groups (p<0,05). There was no significant difference between the sham group, probiotic group and probiotic+enema group in the tissue epression levels of TNF-alphaOur study has shown that there is no benefit in using enema in acute pancreatitis in the means of reducing septic complications. Enema can even augment the septic complications in acute pancreatitis. Our data show that the probiotic agent S. boulardii may be beneficial in the prevention of infectious complications of acute pancreatitis. The mechanism by which probiotics and enema reduce the expression of TNF-alpha in the pancreatic tissue during acute pancreatitis and the clinical significance of this phenomenon remains to be explained by future studies.