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World J Gastroenterol. Sep 21, 2026; 32(35): 118836
Published online Sep 21, 2026. doi: 10.3748/wjg.118836
Published online Sep 21, 2026. doi: 10.3748/wjg.118836
Polyethylene glycol-based bowel preparation and gut dysbiosis: Clinical implications beyond colon cleansing
Ana Clara Correia Melgaço, Department of Biological Sciences, State University of Santa Cruz, Ilhéus 45662-900, Bahia, Brazil
Adriano Francisco Alves, Wallace Felipe Blohem Pessoa, Department of Biomedical Sciences, Federal University of Paraíba, João Pessoa 58050-585, Paraíba, Brazil
Author contributions: Pessoa WFB contributed to conceptualization, writing, reviewing and editing; Melgaço ACC and Alves AF wrote the original draft; Melgaço ACC and Alves AF participated in drafting the manuscript; and all authors have read and approved the final version of the manuscript.
AI contribution statement: The scientific concepts, manuscript structure, literature selection, interpretation of evidence, critical analysis, and final intellectual content were conceived, developed, and validated by the authors. ChatGPT was used to assist with language refinement, grammar correction, sentence restructuring, improvement of readability, and editorial polishing of selected sections of the manuscript. All AI-assisted suggestions were critically reviewed, modified when necessary, and approved by the authors. The AI tool did not participate in study conception, literature selection, scientific interpretation, critical analysis, formulation of hypotheses, or development of conclusions.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Wallace Felipe Blohem Pessoa, PhD, Adjunct Professor, Department of Biomedical Sciences, Federal University of Paraíba, Via Pau Brasil, S/N, João Pessoa 58050-585, Paraíba, Brazil. wall.bmd@gmail.com
Received: January 20, 2026
Revised: February 16, 2026
Accepted: June 9, 2026
Published online: September 21, 2026
Processing time: 211 Days and 12.3 Hours
Revised: February 16, 2026
Accepted: June 9, 2026
Published online: September 21, 2026
Processing time: 211 Days and 12.3 Hours
Core Tip
Core Tip: Polyethylene glycol (PEG)-based bowel preparation may transiently alter gut microbial diversity, mucus barrier integrity, and short-chain fatty acid production. Although these ecological changes are increasingly associated with immune modulation and postoperative outcomes, current evidence remains heterogeneous and largely observational. Suitably, this opinion review critically examines the mechanisms and potential clinical implications of PEG-induced dysbiosis. The review also emphasizes the need for microbiota-preserving bowel preparation strategies and personalized approaches based on host resilience and baseline microbiota composition.