Benefits of Probiotic Pretreatment on the Gut Microbiota and Minor Complications after Bowel Preparation for Colonoscopy: A Randomized Double-Blind, Placebo-Controlled Pilot Trial

Abstract

The aim of this study was to evaluate the effects of probiotic pretreatment on the alteration and recovery of gut microbiota after bowel preparation and its correlation with minor complications. This was a randomized, double-blind, placebo-controlled pilot trial that included participants 40–65 years of age. Participants were randomly provided probiotics (active group) or placebo (placebo group) for 1 month before the colonoscopy and their feces collected. A total of 51 participants were included in the present study (26 in the active group and 25 in the placebo group). In the active group, the microbial diversity, evenness, and distribution were not significantly changed between before and after bowel preparation, but did change in the placebo group. The number of gut microbiota that decreased after bowel preparation in the active group was lower than in the placebo group. On the seventh day after colonoscopy, the gut microbiota in the active group was restored to almost the same level as before bowel preparation. In addition, we identified that several strains were assumed as key microbiota in early colonization and some taxa were increased only in the active group after bowel preparation. In multivariate analysis, taking probiotics before bowel preparation was identified as a significant factor for decreasing the duration of minor complications (odds ratio 0.13, 95% confidence interval 0.02–0.60, p = 0.027). Probiotic pretreatment had benefits on the alteration and recovery of gut microbiota and possible complications after bowel preparation. Probiotics may also aid in the early colonization of key microbiota.

Utilization of Probiotics in Relieving Post-Colonoscopy Gastrointestinal Symptoms: A Systematic Review and Meta-Analysis.

“…A total of six included studies [19,[21][22][23][26][27] in the quantitative synthesis showed numerous results in before and after-colonoscopy groups, as shown in Table 2.A and 2.B, respectively. Souza et al [23] reported a statistically significant reduction in abdominal pain symptoms in before colonoscopy probiotics groups (p=0.032).…”

“…Among the nine studies evaluated using ROB-2, eight had a low risk of bias, while one by Son et al [19] had a high risk. Concurrently, one quasi-experimental study by Bonavina et al [20] was considered as having some risk of bias concern.…”

“…The inclusion criteria were met by a total of 10 studies, including six on probiotics after colonoscopy [20,[23][24][25][26][27] three on probiotics before colonoscopy [19,[21][22], and one that assessed probiotics use in both conditions [12]. The participants included a total of 341 patients receiving probiotics before colonoscopy and 340 in the placebo groups.…”

“…The included studies were nine randomized controlled trial (RCT) studies [12,19,[21][22][23][24][25][26][27] and one quasi-experimental study [20]. The mean ages of probiotics group compared with the placebo ranged from 32.97±10.79 to 61.62 ± 13.75 years and 35.15±11.20 to 60.13 ± 12.81, respectively.…”

“…Furthermore, the inclusion criteria, doses, duration, and frequency of probiotics varied across studies. The type of probiotics used were Bifidobacterium [19,21,[23][24][26][27], Lactobacillus [12,19,20,[23][24][26][27], Enterococcus [25][26], Streptococcus [19,22,24], and Bacillus [22,25], with the most common being Lactobacillus and Bifidobacterium. The participants of each study were adults either male or female with abdominal complaints or elective colonoscopy.…”