Impact of Colonoscopy Bowel Preparation on Intestinal Microbiota

Abstract

The gut microbiota is important in maintaining human health, but numerous factors have the potential to alter its composition. Our aim was to examine the impact of a standard bowel preparation on the intestinal microbiota using two different techniques. Fifteen subjects undergoing colonoscopy consumed a bowel preparation comprised of 10 mg bisacodyl and 2 L polyethylene glycol. The microbiota of stool samples, collected one month before, one week before (pre-colonoscopy), and one week, one month, and three to six months after colonoscopy (post-colonoscopy) was evaluated. Two samples were taken three to six months apart from five healthy subjects who did not undergo colonoscopy. Universal primers targeting the V2–V3 region of the 16S rRNA gene were used to PCR amplify all samples for denaturing gradient gel electrophoresis (PCR-DGGE). Pre- and post-colonoscopy samples were compared using Dice’s similarity coefficients. Three samples from ten subjects who underwent colonoscopy, and both samples from the five subjects who didn’t, were used for high-throughput sequencing of the V1–V3 region of the 16S rRNA gene. Samples were curated and analysed in Mothur. Results of the DGGE analyses show that the fecal microbiota of a small number of subjects had short-term changes. High-throughput sequencing results indicated that the variation between the samples of subjects who underwent colonoscopy was no greater than the variation observed between samples from subjects who did not. We conclude that bowel preparation does not have a lasting effect on the composition of the intestinal microbiota for the majority of subjects.

The role of inflammation in temporal shifts in the inflammatory bowel disease mucosal microbiome

“…Our group has previously demonstrated that bowel preparation and colonoscopy does not change the microbiota in most subjects, 30 but noted that three patients suffering from ulcerative colitis did not have restoration of their pre-colonoscopy microbiome. Therapeutic manipulation of the microbiome, for example with faecal microbial transplantation, has had mixed results in IBD cohorts compared to those with recurrent Clostridium difficile colitis, 31 , 32 also raising the possibility that there is instability of the microbiome in IBD patients compared to previously healthy subjects.…”

Novel insight into the role of microbiota in colorectal surgery

“…Harrel et al 47 split the subjects into three groups to compare the impact on the microbiota of MBP or a liquid diet for 24 hours with no bowel preparation (box 2). O'Brien et al 48 analysed the microbiota in stool samples collected 1 month and 1 week before and 1 week, 1 month and 3 months after MBP using denaturing gradient gel electrophoresis (DGGE) and high-throughput sequencing (HTS) methods. Jalanka et al 49 was the first (and at present, the only) study to examine the effect of two cleansing regimens on faecal microbiota composition.…”

Assessing the Colonic Microbiota in Children

“…significantly affect the gut microbiota in the long term (24,25). The short term effects of bowel preparation may be due to the majority of the bacteria being washed out in a nondiscriminatory manner, which could reduce low-abundance taxonomic groups to levels below detection; on average, bowel preparation with polyethylene glycol can reduce bacterial load by 34.7-fold (25).…”