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Split-dose bowel cleansing led to fewer intestinal microbiota changes
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Bowel cleansing preparation using two separate doses caused minimal alterations to the intestinal microbiota, whereas a single dose was associated with lasting alterations, according to new research data.
To evaluate the effects of split-dose vs. single-dose bowel cleansing preparation on the intestinal microbiota, researchers randomly assigned 23 healthy participants to a polyethylene glycol (PEG) electrolyte solution (MoviPrep, Salix) in either two separate doses of 1 L or as a single 2-L dose. Fecal samples were collected at baseline, after bowel cleansing, at 14 days and at 28 days after treatment, and intestinal microbiota composition was assessed by phylogenetic microarray and quantitative polymerase chain reaction analysis.
They found that total microbial load was reduced 34.7-fold on average immediately after the lavage (P<.001); methanogenic archaea per gram was reduced 20-fold (P<.001); similarity of microbial profiles was reduced (P<.05); and 22% of participants lost the subject-specificity of their microbiota. After treatment, participants who received the single dose had a higher bacterial load vs. those who received the split dose (25.3-fold vs. 64.7-fold changes; P<.05), less efficient microbial recovery, and greater levels of Proteobacteria, Fusobacteria and bacteria related to Dorea formicigenerans in their follow-up samples. Bacterial levels and microbiota composition essentially returned to baseline by 14 days.
“Overall, our results indicate that bowel cleansing has a limited effect on the subjects’ intestinal microbiota,” the researchers concluded. “We show that the microbiota recovers to resemble the baseline composition when the PEG electrolyte solution was consumed in two 1 L doses. “However, when only the single 2-L dose was consumed, the microbiota differed from the baseline sample, up to 1 month after treatment. Microbial recovery rate and temporal instability have been associated with several GI conditions. Hence, it is plausible to hypothesize that an already depleted microbiota might suffer with the single dosing method.”
Disclosure: One of the study researchers reports advisory or financial ties with Abbott, Almirall, Danone, Ironwood, Norgine and Shire.
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