Oral Probiotics Alleviate Intestinal Dysbacteriosis for People Receiving Bowel Preparation

Abstract

Background: Bowel preparation is necessary for successful colonoscopy, while it can seriously affect intestinal microbial composition and damage the intestinal mucosal barriers in humans. Methods: To figure out whether probiotics can sustain intestinal homeostasis and guard people's health, the probiotic drug of Bifidobacterium Tetragenous viable Bacteria Tablets (P group, n = 16) or placebo (C group, n = 16) was used for volunteers receiving bowel preparation, and high-throughput sequencing method was applied to monitor their intestinal microbial changes. Results: The present results suggested that bowel preparation obviously reduced the intestinal microbial diversity, while taking probiotics significantly restored it to normal level. In addition, probiotics sharply reduced the abundance of pathogenic Proteobacteria, and obviously lowered the ratio of Firmicutes/Bacteroidetes compared with control group at phylum level (P < 0.05). And probiotics markedly decreased the abundance of pathogenic Acinetobacter and Streptococcus, while greatly enriched the relative abundance of beneficial bacteria Bacteroides, Roseburia, Faecalibacterium, and Parabacteroides at genus level (P < 0.05). Conclusion: Probiotic drugs, e.g., Bifidobacterium Tetragenous viable Bacteria Tablets, can be used to restore intestinal dysbacteriosis caused by bowel preparation, and reduce side effects during colonoscopy.

Keywords: Firmicutes/Bacteroidetes; Proteobacteria; bowel preparation; high-throughput sequencing; probiotics.

Figure 1

Effect of bowel preparation on intestinal microbiota. (A), Shannon index; (B), Simpson index; (C), Observed species; (D), PCoA of β diversity index; (E), scalar-Venn representation. CB, control group 3 days before bowel preparation (n = 16); CM, control group during bowel preparation (n = 16); CA, control group 5–7 days after bowel preparation (n = 16). Data are presented as means ± SD. ns, P > 0.05; ^*P < 0.05.

Figure 2

Effect of bowel preparation on microbial composition at phylum and genus levels. (A), the relative abundance of intestinal microbiota at the phylum level; (B), Proteobacteria; (C), Bacteroidetes; (D), Firmicutes; (E), Actinobacteria. (F), the relative abundance of intestinal microbiota at the genus level; (G), Acinetobacter; (H), Bifidobacterium; (I), Streptococcus; (J), Faecalibacterium. CB, control group 3 days before bowel preparation (n = 16); CM, control group during bowel preparation (n = 16); CA, control group 5–7 days after bowel preparation (n = 16). Data are presented as means ± SD. ns, P > 0.05; ^*P < 0.05.

Figure 3

Effect of probiotics on intestinal microbiota. (A), Shannon index; (B), Simpson index; (C), Observed species; (D), PCoA of β diversity index; (E), scalar-Venn representation. PB, probiotic group 3 days before bowel preparation (n = 16); PM, control group during bowel preparation (n = 16); PA, probiotic group 5–7 days after bowel preparation (Supplement the Bifidobacterium Tetragenous viable Bacteria Tablets after colonoscopy for up to 5–7 days, three tablets and three times a day) (n = 16). Data are presented as means ± SD. ns, P > 0.05; ^*P < 0.05.

Figure 4

Effect of probiotics on microbial composition at phylum and genus levels. (A), the relative abundance of intestinal microbiota at the phylum level; (B), Proteobacteria; (C), Bacteroidetes; (D), Firmicutes; (E), Actinobacteria. (F), the relative abundance of intestinal microbiota at the genus level; (G), Acinetobacter; (H), Bifidobacterium; (I), Bacteroides; (J), Faecalibacterium. PB, probiotic group 3 days before bowel preparation (n = 16); PM, control group during bowel preparation (n = 16); PA, probiotic group 5–7 days after bowel preparation (Supplement the Bifidobacterium Tetragenous viable Bacteria Tablets after colonoscopy for up to 5–7 days, three tablets and three times a day) (n = 16). Data are presented as means ± SD. ns, P > 0.05; ^*P < 0.05; ^**P < 0.01.

Figure 5

The microbial changes between groups CA and PA. (A), Shannon index; (B), Simpson index; (C), Observed species; (D), PCoA of β diversity index; (E), scalar-Venn representation; (F), Lefse index. CA, control group 5–7 days after bowel preparation (n=16); PA, probiotic group 5–7 days after bowel preparation (Supplement the Bifidobacterium Tetragenous viable Bacteria Tablets after colonoscopy for up to 5–7 days, three tablets and three times a day) (n = 16). Data are presented as means ± SD. ^*P < 0.05.

Figure 6

Effect of probiotics on microbial composition between groups CA and PA at phylum and genus levels. (A), the relative abundance of intestinal microbiota at the phylum level; (B), Proteobacteria; (C), Bacteroidetes; (D), Firmicutes. (E), the relative abundance of intestinal microbiota at the genus level; (F), Acinetobacter; (G), Bacteroides; (H), Streptococcus; (I), Roseburia; (J), Faecalibacterium; (K), Parabacteroides. CA, control group 5–7 days after bowel preparation (n = 16); PA, probiotic group 5–7 days after bowel preparation (Supplement the Bifidobacterium Tetragenous viable Bacteria Tablets after colonoscopy for up to 5–7 days, three tablets and three times a day) (n = 16). Data are presented as means ± SD. ^*P < 0.05.