Review
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Alteration in gut microbiota after colonoscopy: proposed mechanisms and the role of probiotic interventions
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Hyeong Ho Jo, Moon Young Lee, Se Eun Ha, Dong Han Yeom, Yong Sung Kim
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Clin Endosc 2025;58(1):25-39. Published online September 2, 2024
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DOI: https://doi.org/10.5946/ce.2024.147
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Abstract
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- Colonoscopy, a widely used procedure for diagnosing and treating colonic diseases, induces transient gastrointestinal symptoms and alterations in the gut microbiota. This review comprehensively examines the evidence on alterations in the gut microbiota following colonoscopy and their possible mechanisms. Factors such as rapid colonic evacuation, increased osmolality, and mucus thinning caused by bowel preparation and exposure to oxygen during the procedure contribute to these alterations. Typically, the alterations revert to the baseline within a short time. However, their long-term implications remain unclear, necessitating further investigation. Split-dose bowel preparation and CO2 insufflation during the procedure result in fewer alterations in the gut microbiota. Probiotic administration immediately after colonoscopy shows promise in reducing alterations and gastrointestinal symptoms. However, the widespread use of probiotics remains controversial due to the transient nature of both the symptoms and gut microbial alterations following a colonoscopy. Probiotics may offer greater benefits to individuals with preexisting gastrointestinal symptoms. Thus, probiotic administration may be a viable option for selected patients.
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Citations
Citations to this article as recorded by

- Response to Ge and Chen
Akira Higashimori, Natsumi Maeda, Yasuhiro Fujiwara
American Journal of Gastroenterology.2025;[Epub] CrossRef - Is It Advisable to Use Probiotics Routinely After a Colonoscopy? A Rapid Comprehensive Review of the Evidence
Matteo Piciucchi, Alice Rossi, Alissa Satriano, Raffaele Manta
Medical Sciences.2025; 13(2): 76. CrossRef - Efficacy of Fecal Microbial Transplantation for Improving Symptoms of Irritable Bowel Syndrome - A Pilot Study for Voluntary Participants in Korea
Jung Won Lee, Nayoung Kim
The Korean Journal of Gastroenterology.2024; 84(4): 168. CrossRef
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Crossref
Focused Review Series: Future Perspectives of Fecal Microbiota Transplatation
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Fecal Microbiota Transplantation beyond Clostridioides Difficile Infection
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Chang Mo Moon, Sung Noh Hong
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Clin Endosc 2021;54(2):149-151. Published online March 26, 2021
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DOI: https://doi.org/10.5946/ce.2021.068
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Abstract
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- With advancing analytical methods for gut microbes, many studies have been conducted, revealing that gut microbes cause various diseases, including gastrointestinal and non-gastrointestinal diseases. Accordingly, studies have been actively conducted to analyze the effects on the prevention and treatment of these diseases through changes in intestinal microbes and control of dysbiosis. Fecal microbiota transplantation (FMT) is an effort and is currently being applied to Clostridioides difficile treatment in Korea. Many studies have demonstrated the application of FMT in inflammatory bowel disease, irritable bowel syndrome, non-alcoholic fatty liver disease, metabolic syndrome, obesity, and diabetes. With further studies and accumulation of evidence, FMT could help treat presently untreatable diseases in clinical practice.