Some good news and some bad news

This column is written by Stig Bengmark – Professor Emeritus, scientist, lecturer and writer. Read more of Stig Bengmark’s columns here.

I’ve been a surgeon throughout my working life. I was one of the pioneers of extensive abdominal surgery, especially of the larger abdominal organs. With cancer, the entire pancreas or up to 75 percent of the liver can often be removed. Unfortunately, this didn’t always go as well as I had hoped – severe infections often occurred. It bothered me that I could never issue a guarantee for the product I had ‘marketed’. Often I’d have to cancel holidays or trips abroad because of a critical situation with a patient on whom I had operated.

One day, I was given a new perspective, like a gift from the gods. I had asked a young doctor named Henrik Ekberg, later to become a professor of transplantation, to properly study the 81 most recent major liver operations. Suddenly, he knocked on my door with what he called both ‘good and bad news’. First, he ‘floored’ me by telling me that the antibiotics that should definitely be given for a week after the operation, according to the standard practice of the time, had actually been forgotten. Shock, horror – how could this happen, and at a university clinic, where we’re supposed to be role models?

When I sunk into the sofa, exhausted, he suddenly said:

‘But Stig – I have good news, too! It was the patients that took antibiotics that got infected. The ones that didn’t get antibiotics didn’t have any infections’.

That changed everything. Maybe the antibiotics had killed the healthy gut flora? The thought drove me to start researching gut flora and looking for methods to restore it when it’s been destroyed – and it’s the same today. It started with me taking the initiative for what eventually became Probi, a Swedish-listed biotechnology company that develops probiotics. From there, I carried on and developed Synbiotic 2000. The information from a scientific study by the Norwegian immunology professor, Per Brandzaeg, that 70-80 percent of the immune system resides in the gut gave me the enthusiasm to continue with my research – it’s in the gut that the majority of important immunoglobulin is formed that trains immune cells on how to perform their tasks around the body.

Still today, you’ll be amazed to hear, people in many places are still casually giving antibiotics as part of surgeries, and this is despite the fact that study after study has shown that it has a negative effect or gives a negative trade-off. Even today, as many as every third patient gets infected after major abdominal surgery – after a liver transplant, it’s every second patient.

My mission is not over.