Abstract
The gut is undoubtedly a very sensitive organ that has a significant immunological and metabolic function. The gut barrier is a decisive factor in the defense against infection and complications of endotoxin and bacteria translocation due to nutritional disorders, catabolism, malnutrition and chemical and physical damage (chemotherapy, ionizing radiation).
Last but not least, there is a significant influence of the intestinal-brain axis and influence of regulatory and cognitive functions based on this system. For these and other metabolic and nutritional reasons, it is clear that gut function maintenance regimen is one of the essential measures during oncological diseases and especially their treatment.
The intestinal mucosa represents a huge contact area with an environment that is populated with a large amount of microorganism. In addition, the intestinal mucosa is very sensitive to chemical nutritional and physical effects associated with rapid cell division of the intestinal mucosa and its extremely rapid anatomical and functional recovery.
The mucosa of the small and large gut is significantly dependent on specific nutritional substrates on the one hand and on the composition of the microbial flora on the other. Nutritional characteristics include the necessary availability of glutamine for the small intestine cells, while short fatty acids - acetic, propionic and butyric acids - are a major energy substrate and a precondition for colonization and differentiation of colonocytes.
If these three short fatty acids are not present in sufficient quantities in the intestinal lumen, the colon mucosa is impaired with all major consequences, such as pathologically increased intestinal barrier permeability, impaired transport of water and ion across the intestinal mucosa interface, in particular, and sodium, potassium and bicarbonate. Thus, it is evident that the inadequate composition of the intestinal flora and the associated impaired availability of short fatty acids leads to major disorders of the anatomical and functional conditions of the intestinal mucosa.
The maintenance of the physiological function of the intestinal flora depends both on its supplementation with food and on suitable substrates, which are the source of energy for the intestinal microflora. Thus, it is a very complex, balanced and relatively fragile balance between the needs of the intestinal mucosa, the living microflora in the lumen of the intestine, and the availability of substrates necessary to maintain the intestinal microflora in the desired composition.
This equilibrium greatly depends on the interplay of microflora supplemented by probiotics and nutritional substrates that induce growth and activity of the intestinal microflora.