Intest Res.  2021 Jul;19(3):341-348. 10.5217/ir.2020.00057.

Effect of gut microbiome on minor complications after a colonoscopy

• Kim JH
• Choi YJ
• Kwon HJ
• Jung K
• Kim SE
• Moon W
• Park MI
• Park SJ

• KMID: 2518690
• DOI: http://doi.org/10.5217/ir.2020.00057

Abstract

Background/Aims
Minor complications that might occur after colonoscopy, including abdominal discomfort, bloating, diarrhea, and constipation, could a barrier for patients to undergo a screening colonoscopy. In this study, we aimed to identify the effect of gut microbial diversity and composition on minor complications after colonoscopy.
Methods
A total of 24 healthy subjects provided their stools before bowel preparation and on the 7th and 28th day after colonoscopy. On the 7th day after colonoscopy, the presence of minor complications was investigated using a questionnaire. We divided patients into 2 groups, the no complication group and complications group. The fecal microbial diversity, distribution, and composition were then compared between the groups.
Results
Five of the 24 subjects reported that they had undergone minor complications after colonoscopy. Most of the symptoms were mild and self-limited, but 1 patient needed medication. Interestingly, the Firmicutes/Bacteroidetes ratio of the initial stool samples before bowel preparation in the complication group was significantly higher than that in no complication group. After bowel preparation, the Firmicutes/Bacteroidetes ratio of the complication group decreased, but not in the no complication group. The microbial diversity of the no complication group decreased after bowel preparation, but not in the complication group.
Conclusions
The gut microbial composition and diversity before and after bowel preparation could be considered as one of the causes of minor complications after colonoscopy. Further studies are needed to delineate the role of gut microbiota in the occurrence of minor complications after colonoscopy.

Keyword

Gut microbiota; Adverse effects; Cathartics; Colonoscopy

Figure

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  Fig. 1. Box plot for the alpha-diversity of bacterial communities in the 2 groups–no complication group (NC) and complication group (C)–according to the timing of the stool collection (1, before bowel preparation; 2, on the 7th day after colonoscopy; 3, on the 28th day after colonoscopy). The box plot presents the full range of values obtained from the source data. The ggplot of the R software package was used for visualization (aP<0.05).

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  Fig. 2. Beta-diversity visualized using the non-metric multidimensional scaling (NMDS) plot with Bray-Curtis dissimilarity distances of the 2 groups–no complication group (NC) and complication group (C)–according to the timing of the stool collection (1, before bowel preparation; 2, on the 7th day after colonoscopy; 3, on the 28th day after colonoscopy).

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  Fig. 3. Composition of bacterial communities at the phylum level in the 2 groups–no complication group (NC) and complication group (C)–according to the timing of the stool collection (1, before bowel preparation; 2, on the 7th day after colonoscopy; 3, on the 28th day after colonoscopy).

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  Fig. 4. Comparison of the Firmicutes/Bacteroidetes ratio of the initial stool sample before bowel preparation in the 2 groups –no complication group (NC) and complication group (C). aWilcoxon signed-rank test, P=0.01.

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