Agrawal H, Agarwal N, Gupta N. Impact of gut microbiome on outcomes following endoscopic interventions in gastrointestinal disease. World J Gastrointest Endosc 2025; 17(11): 110207 [PMID: 41256293 DOI: 10.4253/wjge.v17.i11.110207]
Corresponding Author of This Article
Nikhil Gupta, Professor, Department of Surgery, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, BKS Marg, Delhi 110001, India. nikhil_ms26@yahoo.co.in
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Gastroenterology & Hepatology
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Systematic Reviews
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 16, 2025 (publication date) through Dec 11, 2025
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World Journal of Gastrointestinal Endoscopy
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1948-5190
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Agrawal H, Agarwal N, Gupta N. Impact of gut microbiome on outcomes following endoscopic interventions in gastrointestinal disease. World J Gastrointest Endosc 2025; 17(11): 110207 [PMID: 41256293 DOI: 10.4253/wjge.v17.i11.110207]
World J Gastrointest Endosc. Nov 16, 2025; 17(11): 110207 Published online Nov 16, 2025. doi: 10.4253/wjge.v17.i11.110207
Impact of gut microbiome on outcomes following endoscopic interventions in gastrointestinal disease
Himanshu Agrawal, Nitin Agarwal, Nikhil Gupta
Himanshu Agrawal, Department of Surgery, University College of Medical Sciences (University of Delhi), GTB Hospital, Delhi 110095, India
Nitin Agarwal, Nikhil Gupta, Department of Surgery, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, Delhi 110001, India
Author contributions: Agrawal H took charge of drafting the manuscript; Agrawal H and Gupta N were responsible for the research conception and design; Agrawal H, Agarwal N, and Gupta N were jointly responsible for data acquisition, data analysis and interpretation, critical revision of the manuscript, supervision; and all authors thoroughly reviewed and endorsed the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nikhil Gupta, Professor, Department of Surgery, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, BKS Marg, Delhi 110001, India. nikhil_ms26@yahoo.co.in
Received: June 3, 2025 Revised: June 12, 2025 Accepted: September 23, 2025 Published online: November 16, 2025 Processing time: 167 Days and 0.9 Hours
Abstract
BACKGROUND
Endoscopic interventions play a vital role in diagnosing and managing gastrointestinal diseases, but complications such as bleeding, infection, and delayed healing can adversely affect patient outcomes. The influence of the gut microbiome on these outcomes is increasingly being recognized.
AIM
To evaluate the role of the gut microbiome in influencing clinical outcomes after endoscopic interventions, focusing on microbial diversity, specific taxa, metabolic functions, and emerging predictive models.
METHODS
A systematic literature search was conducted in PubMed, EMBASE, and Cochrane databases up to May 2025, selecting human studies that analyzed gut microbiome composition or function in relation to endoscopic interventions and clinical outcomes. Microbiome analysis techniques included 16S rRNA gene sequencing, metagenomics, and metabolomics.
RESULTS
Forty-two studies met the inclusion criteria. Our review identifies key beneficial microbes, such as Faecalibacterium prausnitzii and Bacteroides spp., which support mucosal healing. In contrast, dysbiosis (e.g., an increased abundance of Proteobacteria) is associated with poorer healing and higher complication rates. Notably, microbiome-informed predictive models have shown strong potential for forecasting post-procedural complications, offering a pathway to personalized treatment strategies. Probiotics have also emerged as a promising intervention, helping to restore microbial balance and reduce complications such as infection and delayed healing.
CONCLUSION
The gut microbiome plays a significant role in recovery after endoscopy. Integrating microbiome analysis into clinical decision-making could improve outcomes through personalized predictions and targeted therapies. Future research should focus on standardizing microbiome assessment protocols and validating predictive models to optimize patient care.
Core Tip: The gut microbiome critically influences patient outcomes after endoscopic procedures by modulating mucosal healing and inflammation. Disruptions from bowel preparation and the procedures affect microbial balance, with targeted probiotic and microbiome-based therapies offering promising recovery improvements. Integration of multi-omics and machine learning enables personalized prediction and management of complications, marking a shift toward precision medicine in gastrointestinal endoscopy.
