The impact of faecal diversion on the gut microbiome: a systematic review

The impact of faecal diversion on the gut microbiome: a systematic review

Diversion of the faecal stream is associated with diversion colitis (DC). Preliminary studies indicate that microbiome dysbiosis contributes to its development and potentially treatment. This review aims to characterise these changes in the context of faecal diversion and identify their clinical imp...

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Bibliographic Details
Published in:Gut microbiome (Cambridge, England) Vol. 5; p. e4
Main Authors: Sam, Shien Wenn, Hafeez, Bilal, Ong, Hwa Ian, Gill, Sonia, Smibert, Olivia, Lavelle, Aonghus, Burgess, Adele, Proud, David, Mohan, Helen
Format: Journal Article
Language:English
Published: England Cambridge University Press 2024
Subjects:
Abscesses
Colitis
Colon
colostomy
Commensals
Crohns disease
Digestive system
diversion
Dysbacteriosis
dysbiosis
ileostomy
Inflammatory bowel disease
Intestinal microflora
Lactic acid bacteria
microbiome
Microbiomes
Microbiota
Mini Review
Ostomy
Ovaries
stoma
Surgical anastomosis
microbiota
colostomy
ileostomy
diversion
stoma
microbiome
dysbiosis
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Summary:Diversion of the faecal stream is associated with diversion colitis (DC). Preliminary studies indicate that microbiome dysbiosis contributes to its development and potentially treatment. This review aims to characterise these changes in the context of faecal diversion and identify their clinical impact. A systematic search was conducted using MEDLINE, EMBASE and CENTRAL databases using a predefined search strategy identifying studies investigating changes in microbiome following diversion. Findings reported according to PRISMA guidelines. Of 743 results, 6 met inclusion criteria. Five reported significantly decreased microbiome diversity in the diverted colon. At phylum level, decreases in Bacillota with a concomitant increase in Pseudomonadota were observed, consistent with dysbiosis. At genus level, studies reported decreases in beneficial lactic acid bacteria which produce short-chain fatty acid (SCFA), which inversely correlated with disease severity. Significant losses in commensals were also noted. These changes were seen to be partially reversible with restoration of bowel continuity. Changes within the microbiome were reflected by histopathological findings suggestive of intestinal dysfunction. Faecal diversion is associated with dysbiosis in the diverted colon which may have clinical implications. This is reflected in loss of microbiome diversity, increases in potentially pathogenic-associated phyla and reduction in SCFA-producing and commensal bacteria.
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S.W.S., B.H. and H.I.O. are authors who contributed equally to this manuscript.
ISSN:2632-2897
2632-2897
DOI:10.1017/gmb.2024.1