Effects of red ginseng on gut microbiome in patients after gastrointestinal cancer surgery: A pilot, randomized controlled trial

Abstract

Background The gut microbiome plays diverse roles in human health. Although Korean red ginseng (KRG) has shown therapeutic potential in animal models, its effects on the human gut microbiome after gastrointestinal (GI) cancer surgery remain underexplored. This prospective randomized controlled study aimed to evaluate postoperative safety of KRG and its impact on the gut microbiome and postoperative outcomes after GI cancer surgery. Methods Patients were randomly assigned 1:1 to the red ginseng or control groups. Microbiome analysis of preoperative and postoperative fecal samples was performed using 16S rRNA sequencing. The alpha and beta diversities, taxonomic composition changes of microbiome, nutritional index, clinical symptoms, GI symptoms, and quality of life (QOL) were assessed. Results A total of 60 patients were enrolled and 16 patients in the red ginseng group and 25 in the control group were included in the final analysis. Postoperative alpha diversity decreased significantly in the control group, but remained relatively stable in the red ginseng group<bold>.</bold> Postoperative Lactobacillus levels increased significantly in the red ginseng group compared to the control group (18.34 % vs. 0.23 %; p < 0.001), whereas Bifidobacterium levels decreased (p = 0.002). Serum albumin levels were significantly higher in the red ginseng group at 3 months postoperatively (p = 0.003), and global health status/QOL scores were improved in the red ginseng group (p = 0.047). Conclusion Red ginseng supplementation may play a protective role in gut microbiome, improving clinical outcomes in patients undergoing GI cancer surgery, as a safe and supportive therapy for enhancing postoperative recovery.