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All Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research
Yora Nintida
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Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience

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Journal : Bioscientia Medicina : Journal of Biomedicine and Translational Research

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Beta vulgaris Extract as a Post-Cholecystectomy Dietary Intervention: A Systematic Review of its Effects on Gut Microbial Balance, Bile Acid Metabolism, and E. Coli/Lactobacillus Dynamics Benedick Johanes Alvian; Sigit Adi Prasetyo; Yora Nintida
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 5 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i5.1267

Abstract

Background: Cholecystectomy, while a common surgical procedure, significantly alters bile acid dynamics and the gut microbiome, potentially leading to an imbalance favoring opportunistic pathogens like Escherichia coli over beneficial bacteria like Lactobacillus. This systematic review investigates the potential of beetroot (Beta vulgaris) extract, rich in betalains and prebiotic fibers, as a dietary intervention to mitigate these post-cholecystectomy microbial shifts. Methods: A systematic search of PubMed, Scopus, Web of Science, and Cochrane Library databases was conducted for studies published between 2013 and 2024. Keywords included "cholecystectomy," "gallbladder removal," "bile acids," "Escherichia coli," "Lactobacillus," "beetroot," "Beta vulgaris," "prebiotic," "gut microbiome," and related terms. Studies investigating the effects of Beta vulgaris (or its constituents) on gut microbial composition, bile acid metabolism, or relevant clinical outcomes in post-cholecystectomy contexts (human or animal models) were included. Quality assessment was performed using the Cochrane Risk of Bias 2.0 tool for randomized controlled trials (RCTs) and the ROBINS-I tool for non-randomized studies. Results: Seven studies met the inclusion criteria: three human RCTs, two animal studies (rats), and two in vitro studies. The human studies were of moderate to high risk of bias. The animal studies had a lower risk of bias but limited direct applicability to humans. The in vitro studies provided mechanistic insights but lacked the complexity of the in vivo environment. Due to the heterogeneity of study designs and outcome measures, a meta-analysis was not feasible. Beetroot extract supplementation (standardized to betalain content) was associated with a significant increase in Lactobacillus abundance (mean increase of 15%, p < 0.05) and a decrease in E. coli abundance (mean decrease of 10%, p < 0.05) in the post-cholecystectomy gut. There was also a shift in bile acid profiles, with an increase in secondary bile acids known to be less inhibitory to Lactobacillus. Conclusion: While existing evidence is limited, the theoretical basis and preliminary findings suggest that beetroot extract holds promise as a post-cholecystectomy dietary intervention to promote a healthier gut microbiome. Further high-quality, well-powered RCTs are warranted to confirm these potential benefits and elucidate the underlying mechanisms.
Beetroot (Beta vulgaris) Extract: A Potential Therapeutic Agent for Modulating Post-Cholecystectomy Colonic Inflammation? An In Vivo Evidence Review Mahmudin Ardian Ashadi; Sigit Adi Prasetyo; Yora Nintida
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 4 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i4.1262

Abstract

Background: Cholecystectomy, while a common and effective treatment for symptomatic gallstones, can induce alterations in bile flow and gut microbiota composition, potentially leading to colonic inflammation. Beetroot (Beta vulgaris) extract, rich in betalains, nitrates, and other bioactive compounds, has demonstrated anti-inflammatory and antioxidant properties in various models. This systematic review evaluates the in vivo evidence for the efficacy of beetroot extract in modulating colonic inflammation following cholecystectomy. Methods: A systematic search of PubMed, Scopus, Web of Science, and Embase databases was conducted from January 2013 to May 2024, using keywords related to "beetroot," "Beta vulgaris," "cholecystectomy," "colon," "inflammation," and "in vivo." Studies investigating the effects of beetroot extract on colonic inflammation in animal models post-cholecystectomy were included. Data on inflammatory markers, histological changes, oxidative stress markers, and gut microbiota alterations were extracted. Results: Seven in vivo studies met the inclusion criteria. Beetroot extract administration was associated with significant reductions in colonic levels of pro-inflammatory cytokines (TNF-α, IL-6, IL-1β) in five studies. Data showed an average reduction of TNF-α by 35% (p < 0.01), IL-6 by 28% (p < 0.05), and IL-1β by 42% (p < 0.001) across these five studies. Four studies reported improvements in histological scores of colonic inflammation, indicating reduced tissue damage. Three studies demonstrated a decrease in MPO activity, a marker of neutrophil infiltration, with data showing an average reduction of 25% (p < 0.05). Conclusion: The available in vivo evidence, albeit limited, suggests that beetroot extract possesses significant potential for mitigating colonic inflammation following cholecystectomy. The observed anti-inflammatory effects are likely mediated by a combination of betalain-induced antioxidant and anti-inflammatory actions, nitrate-derived nitric oxide signaling, and modulation of the gut microbiota.
Co-Authors Benedick Johanes Alvian Mahmudin Ardian Ashadi Sigit Adi Prasetyo