Probiotics and Recovery From Gastrointestinal Surgery - 2

Inclusion Criteria: * Adults aged ≥18 years undergoing elective major abdominal operation * Functional GI tract expected after operation Exclusion Criteria: * Current episode of acute necrotizing pancreatitis as defined by surgeon * Palliative decompressive GI tube * Life expectancy ≤ 6 months * Systemic immune-mediated disease active requiring systemic therapy: * Prednisone ≥20 mg QD * IV immunoglobulins * Anti-rejection medication * Presence of functional transplanted organ * Systemic collagen-related disease treated with immunomodulating agents, including rheumatoid arthritis, SLE, scleroderma, etc. * Topical chemotherapy or corticosteroids, and chemotherapy applied during operation are allowed * Patient taking probiotics, synbiotics, or cobiotics as part of their lifestyle * Need for full systemic anticoagulation postoperatively.