Persisting changes of intestinal microbiota after bowel lavage and colonoscopy

Drago, Lorenzo; Toscano, Marco; Grandi, Roberta De; Valentina, Casini; Pace, Fabrizio

doi:10.1097/meg.0000000000000581

Cited by 96 publications

(98 citation statements)

References 33 publications

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“…Jalanka et al [33] demonstrated a decrease in the abundance of the members of Clostridium cluster IV and increased the members of Clostridium cluster XIVa and Proteobacteria. Other studies identifying changes caused by bowel cleansing include Harrell et al [30], O’Brien et al [32], Mai et al [34], Drago et al [35] and Jain et al [36], whilst other studies have failed to demonstrate changes [37–39]. The findings of the current study are most relevant to the type of bowel preparation that we used, i.e.…”

Section: Discussionmentioning

confidence: 62%

Extending colonic mucosal microbiome analysis—assessment of colonic lavage as a proxy for endoscopic colonic biopsies

et al. 2016

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BackgroundSequencing-based analysis has become a well-established approach to deciphering the composition of the gut microbiota. However, due to the complexity of accessing sufficient material from colonoscopic biopsy samples, most studies have focused on faecal microbiota analysis, even though it is recognised that differences exist between the microbial composition of colonic biopsies and faecal samples. We determined the suitability of colonic lavage samples to see if it had comparable microbial diversity composition to colonic biopsies as they are without the limitations associated with sample size. We collected paired colonic biopsies and lavage samples from subjects who were attending for colorectal cancer screening colonoscopy.ResultsNext-generation sequencing and qPCR validation were performed with multiple bioinformatics analyses to determine the composition and predict function of the microbiota. Colonic lavage samples contained significantly higher numbers of operational taxonomic units (OTUs) compared to corresponding biopsy samples, however, diversity and evenness between lavage and biopsy samples were similar. The differences seen were driven by the presence of 12 OTUs which were in higher relative abundance in biopsies and were either not present or in low relative abundance in lavage samples, whilst a further 3 OTUs were present in higher amounts in the lavage samples compared to biopsy samples. However, predicted functional community profiling based on 16S ribosomal ribonucleic acid (rRNA) data indicated minimal differences between sample types.ConclusionsWe propose that colonic lavage samples provide a relatively accurate representation of biopsy microbiota composition and should be considered where biopsy size is an issue.Electronic supplementary materialThe online version of this article (doi:10.1186/s40168-016-0207-9) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 62%

Extending colonic mucosal microbiome analysis—assessment of colonic lavage as a proxy for endoscopic colonic biopsies

et al. 2016

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“…In the same manner, a very recently published paper further underlines that, immediately after bowel lavage, a significant reduction in Lactobacillaceae and an increase in Enterobacteriaceae abundance were prominent; 30 days later these families were still significantly lower, while Streptococcaceae had increased 4-fold compared with samples collected before lavage [23]. …”

Section: Intestinal Microbiota: Symbiosis and Dysbiosismentioning

confidence: 99%

Gut microbiome, surgical complications and probiotics

Stavrou

Kotzampassi

2016

aog

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The trigger for infectious complications in patients following major abdominal operations is classically attributed to endogenous enteral bacterial translocation, due to the critical condition of the gut. Today, extensive gut microbiome analysis has enabled us to understand that almost all “evidence-based” surgical or medical intervention (antibiotics, bowel preparation, opioids, deprivation of nutrition), in addition to stress-released hormones, could affect the relative abundance and diversity of the enteral microbiome, allowing harmful bacteria to proliferate in the place of depressed beneficial species. Furthermore, these bacteria, after tight sensing of host stress and its consequent humoral alterations, can and do switch their virulence accordingly, towards invasion of the host. Probiotics are the exogenously given, beneficial clusters of live bacteria that, upon digestion, seem to succeed in partially restoring the distorted microbial diversity, thus reducing the infectious complications occurring in surgical and critically ill patients. This review presents the latest data on the interrelationship between the gut microbiome and the occurrence of complications after colon surgery, and the efficacy of probiotics as therapeutic instruments for changing the bacterial imbalance.

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“…Aroniadis 2018 gastrointestinal route of administration, reported that they used bowel lavage as part of their FMT protocol. [30][31][32] There is evidence to suggest that bowel lavage itself can alter the faecal microbiota in healthy individuals, 41,42 although whether this in itself has any effect on symptoms in people with IBS is uncertain.…”

Section: Control Intervention (Number Of Patients)mentioning

confidence: 99%

Systematic review with meta‐analysis: efficacy of faecal microbiota transplantation for the treatment of irritable bowel syndrome

Ianiro

Eusebi

Black

et al. 2019

Aliment Pharmacol Ther

167

136

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Summary Background Increasing evidence supports the role of the gut microbiota in the aetiology of irritable bowel syndrome (IBS). Faecal microbiota transplantation (FMT) is a highly effective treatment against recurrent Clostridioides difficile infection in randomised controlled trials (RCTs), and may be beneficial in ulcerative colitis. However, its efficacy in IBS is uncertain. Aim To perform a systematic review and meta‐analysis to examine this issue. Methods We searched MEDLINE, EMBASE, EMBASE Classic, the Cochrane Central Register of Controlled Trials, and clinicaltrials.gov through to March 2019. RCTs recruiting adults with IBS, which compared FMT with placebo, were eligible. Dichotomous symptom data were pooled to obtain a relative risk (RR) of remaining symptomatic after therapy, with a 95% CI. Results The search strategy identified 322 citations. Five RCTs were eligible for inclusion, containing 267 patients. Overall, 92.2% of included patients had IBS‐D or IBS‐M, and only 7.8% IBS‐C. When data were pooled for all patients, irrespective of stool type, the RR of IBS symptoms not improving was 0.98 (95% CI 0.58‐1.66). Placebo capsules administered orally were superior to capsules containing donor stool in two pooled trials (RR = 1.96; 95% CI 1.19‐3.20). FMT from donor stool delivered via colonoscopy was superior to autologous stool in two pooled RCTs (RR = 0.63; 95% CI 0.43‐0.93). FMT from donor stool via nasojejunal tube showed a trend towards a benefit over autologous stool in one trial (RR = 0.69; 95% CI 0.46‐1.02). Conclusions Fresh or frozen donor stool delivered via colonoscopy or nasojejunal tube may be beneficial in IBS. Larger, more rigorously conducted trials of FMT in IBS are needed.

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Persisting changes of intestinal microbiota after bowel lavage and colonoscopy

Cited by 96 publications

References 33 publications

Extending colonic mucosal microbiome analysis—assessment of colonic lavage as a proxy for endoscopic colonic biopsies

Extending colonic mucosal microbiome analysis—assessment of colonic lavage as a proxy for endoscopic colonic biopsies

Gut microbiome, surgical complications and probiotics

Systematic review with meta‐analysis: efficacy of faecal microbiota transplantation for the treatment of irritable bowel syndrome

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