Ghouri Yezaz A, Ericsson Aaron C, Anderson Jennifer M, George Jessica G, Parks Elizabeth J, Anguah Katherene O B
Division of Gastroenterology and Hepatology, School of Medicine, University of Missouri, Columbia, Missouri, United States of America.
Department of Veterinary Pathobiology, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, United States of America.
PLoS One. 2025 Sep 12;20(9):e0320712. doi: 10.1371/journal.pone.0320712. eCollection 2025.
Role of microbiome has been highly studied for its association with various medical conditions. After a colonoscopy, repopulation of colonic microbial load is known to occur, however the quality and timing of natural repopulation has not been investigated after a bowel preparation. Further, no study has documented detailed free-living dietary intakes concurrently with gut microbiome repopulation post-colonoscopy. Here we sought to determine the early pattern of repopulation relative to dietary intake.
Healthy adults (n = 15 [4 female/11 male], BMI = 27.2 ± 3.9 kg/m2, age 51.4 ± 7.2 y) who were scheduled to undergo a screening colonoscopy were recruited from the Gastroenterology Clinic at the University of Missouri. Within two weeks before the colonoscopy (baseline), subjects completed detailed food records for 3 days. Post-colonoscopy, subjects ate their free-living diets and detailed food records were collected on Days 0, 1, 2, 4, 7, 10, and 13. Fecal samples were obtained pre-colonoscopy and on post-colonoscopy Days 3, 5, 8, 11, and 14. Gut microbiome composition was assessed by 16S rRNA amplicon sequencing.
Within 5 days after the procedure, subjects reported consuming more total daily energy relative to baseline, presumably to make up for the low energy intake that occurred during the bowel-prep. At baseline, fiber intake (21.0 ± 9.1 g/d) was higher than on the day of the colonoscopy, Day 0 (16.1 ± 11.2, P = 0.0159). Thereafter, daily fiber intake was the same as baseline. Marked intersubject microbiome beta diversity was observed by principal coordinate analysis using weighted and unweighted dissimilarities (P = 0.0001, F = 15.23, one-way PERMANOVA). Select taxa were depleted acutely post-colonoscopy (e.g., within the phylum Bacillota). Specifically, significant effects of time were observed between baseline and Day 3 fecal samples (pairwise P = 0.0013, F = 2.9). These changes tended to return to baseline by Day 5 and with subsequent samples, taxa remained similar to baseline when tested using a weighted dissimilarity analysis (Bray-Curtis).
These results quantitatively demonstrate the magnitude of the significant changes in microbial relative abundance and diversity immediately post-colonoscopy. The timing of repopulation aligned with changes in fiber intake after the procedure. These data highlight the importance of nutrition after a screening colonoscopy in reestablishing a healthy microbiome.
微生物群与各种医学状况的关联已得到广泛研究。结肠镜检查后，结肠微生物负荷会重新出现，然而，肠道准备后自然重新定植的质量和时间尚未得到研究。此外，尚无研究记录结肠镜检查后肠道微生物群重新定植期间详细的自由生活饮食摄入量。在此，我们试图确定与饮食摄入相关的早期重新定植模式。
从密苏里大学胃肠病学诊所招募计划接受筛查结肠镜检查的健康成年人（n = 15 [4名女性/11名男性]，BMI = 27.2 ± 3.9 kg/m²，年龄51.4 ± 7.2岁）。在结肠镜检查前两周内（基线），受试者完成了3天的详细食物记录。结肠镜检查后，受试者按照自由生活饮食进食，并在第0、1、2、4、7、10和13天收集详细的食物记录。在结肠镜检查前以及结肠镜检查后第3、5、8、11和14天采集粪便样本。通过16S rRNA扩增子测序评估肠道微生物群组成。
在检查后的5天内，受试者报告相对于基线，每日总能量摄入量增加，可能是为了弥补肠道准备期间的低能量摄入。在基线时，纤维摄入量（21.0 ± 9.1 g/天）高于结肠镜检查当天，即第0天（16.1 ± 11.2，P = 0.0159）。此后，每日纤维摄入量与基线相同。使用加权和非加权差异的主坐标分析观察到明显的受试者间微生物群β多样性（P = 0.0001，F = 15.23，单向PERMANOVA）。某些分类群在结肠镜检查后急性减少（例如，在厚壁菌门内）。具体而言，在基线和第3天粪便样本之间观察到时间的显著影响（成对P = 0.0013，F = 2.9）。这些变化在第5天趋于恢复到基线水平，对于后续样本，使用加权差异分析（Bray-Curtis）测试时，分类群与基线相似。
这些结果定量地证明了结肠镜检查后微生物相对丰度和多样性的显著变化程度。重新定植的时间与检查后纤维摄入量的变化一致。这些数据突出了筛查结肠镜检查后营养对于重建健康微生物群的重要性。
