Effects of bowel cleansing on the intestinal microbiota

作者：Jonna Jalanka, Anne Salonen, Jarkko Salojärvi, Jarmo Ritari, Outi Immonen, Luca Marciani, Penny Gowland, Caroline L. Hoad, Klara Garsed, Ching Lam, Airi Palva, Robert E. Spiller, Willem M. de Vos · 发表于：Gut · 年份：2014 · DOI：10.1136/gutjnl-2014-307240 · 被引用次数：279 · 研究领域：Colorectal Cancer Screening and Detection、Medical Device Sterilization and Disinfection、Gastrointestinal motility and disorders

OBJECTIVE: An adequate bowel cleansing is essential for a successful colonoscopy. Although purgative consumption is safe for the patient, there is little consensus on how the intestinal microbiota is affected by the procedure, especially regarding the potential long-term consequences. DESIGN: 23 healthy subjects were randomised into two study groups consuming a bowel preparation (Moviprep), either in two separate doses of 1 L or as a single 2-L dose. Participants donated faecal samples at the baseline, after bowel cleansing, 14 and 28 days after the treatment. The intestinal microbiota composition was determined with phylogenetic microarray as well as quantitative PCR analysis and correlated with the previously quantified faecal serine proteases. RESULTS: The lavage introduced an instant and substantial change to the intestinal microbiota. The total microbial load was decreased by 31-fold and 22% of the participants lost the subject-specificity of their microbiota. While the bacterial levels and community composition were essentially restored within 14 days, the rate of recovery was dose dependent: consumption of the purgative in a single dose had a more severe effect on the microbiota composition than that of a double dose, and notably increased the levels of Proteobacteria, Fusobacteria and bacteria related to Dorea formicigenerans. The abundance of the latter also correlated with the amount of faecal serine proteases that were increased after purging. CONCLUSIONS: Our resu...