A pilot study demonstrating the impact of surgical bowel preparation on intestinal microbiota composition following colon and rectal surgery

Harika Nalluri-Butz, Matt Bobel, Julia Nugent, Sonja Boatman, Ryan Emanuelson, Genevieve Melton-Meaux, Robert D. Madoff, Cyrus Jahansouz, Christopher Staley, Wolfgang B. Gaertner

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


The intestinal microbiota has been implicated in the pathogenesis of complications following colorectal surgery, yet perioperative changes in gut microbiome composition are poorly understood. The objective of this study was to characterize the perioperative gut microbiome in patients undergoing colonoscopy and colorectal surgery and determine factors influencing its composition. Using Illumina amplicon sequencing coupled with targeted metabolomics, we characterized the fecal microbiota in: (A) patients (n = 15) undergoing colonoscopy who received mechanical bowel preparation, and (B) patients (n = 15) undergoing colorectal surgery who received surgical bowel preparation, composed of mechanical bowel preparation with oral antibiotics, and perioperative intravenous antibiotics. Microbiome composition was characterized before and up to six months following each intervention. Colonoscopy patients had minor shifts in bacterial community composition that recovered to baseline at a mean of 3 (1–13) days. Surgery patients demonstrated substantial shifts in bacterial composition with greater abundances of Enterococcus, Lactobacillus, and Streptococcus. Compositional changes persisted in the early postoperative period with recovery to baseline beginning at a mean of 31 (16–43) days. Our results support surgical bowel preparation as a factor significantly influencing gut microbial composition following colorectal surgery, while mechanical bowel preparation has little impact.

Original languageEnglish (US)
Article number10559
JournalScientific reports
Issue number1
StatePublished - Dec 2022

Bibliographical note

Funding Information:
Sequence processing and analysis were done using the resources of the Minnesota Supercomputing Institute.

Funding Information:
This study was funded by the Hubbard Family private fund for advancing treatment practices to improve patient outcomes in colorectal surgery (fund 21692 – University of Minnesota).

Publisher Copyright:
© 2022, The Author(s).

PubMed: MeSH publication types

  • Journal Article
  • Research Support, Non-U.S. Gov't


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