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Post-Surgical Gut Microbiota Alterations in Pediatric Patients with Intestinal Disorders

Natalia Vaou1, Nikolaos Zavras2, Chrysa Saldari1

  • 1Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.

Journal of Clinical Medicine
|January 28, 2026
PubMed

Insights

Surgery can alter gut microbiota (GM) in children, leading to complications like infections and obstructions. More pediatric research is needed to understand and manage these post-surgical GM changes for better outcomes.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Microbiome Research

Background:

  • Surgical interventions for pediatric conditions like necrotizing enterocolitis (NEC), Hirschsprung's disease (HD), inflammatory bowel disease (IBD), and short bowel syndrome (SBS) can significantly impact gut microbiota (GM) composition and diversity.
  • While adult data on post-surgical GM dysbiosis and complications are established, there is a critical lack of pediatric-specific information.
  • Altered GM following pediatric intestinal surgery is linked to potential complications such as surgical infections, intestinal obstructions (IO), and anastomotic leaks (AL).

Purpose of the Study:

  • To review the current understanding of unique alterations in gut microbiota (GM) following surgery for significant childhood intestinal conditions.
  • To highlight the gap in pediatric-specific data regarding post-surgical GM dysbiosis and its associated complications.
  • To emphasize the need for research into perioperative GM modulation in children undergoing intestinal surgery.

Main Methods:

  • This study is a detailed narrative review of existing literature.
  • It synthesizes current knowledge on GM changes and complications after pediatric intestinal surgery.
  • The review focuses on conditions including NEC, HD, IBD, and SBS.

Main Results:

  • Surgical procedures can alter GM diversity and structure, potentially leading to post-surgical complications in children.
  • Current research offers an initial understanding of GM implications for outcomes in pediatric intestinal disorders.
  • A significant knowledge gap exists concerning pediatric-specific post-surgical GM dysbiosis and its complications (e.g., IO, AL).

Conclusions:

  • The identified gap in pediatric data represents both a clinical risk and a therapeutic opportunity.
  • Further research is crucial to clarify GM alterations associated with specific pediatric intestinal surgical procedures and their complications.
  • Understanding these GM changes may guide the development of targeted, GM-modulating treatments for children.

Keywords:
childrendysbiosisgut microbiotaintestinal disorderspost-surgical alterationspost-surgical complicationssurgery

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