Intestinal microbiota characteristics and dietary fiber intervention in patients undergoing endoscopic mucosa resection

doi:10.4240/wjgs.v17.i7.105893

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Gastrointest Surg. Jul 27, 2025; 17(7): 105893
Published online Jul 27, 2025. doi: 10.4240/wjgs.v17.i7.105893

Intestinal microbiota characteristics and dietary fiber intervention in patients undergoing endoscopic mucosa resection

Wen-Cui Niu, Shao-Hua Wang, Ye Zhao

Wen-Cui Niu, Department of Nutrition, Beijing Hospital of Integrated Traditional Chinese and Western Medicine, Beijing 100039, China

Shao-Hua Wang, Ye Zhao, Department of Gastroenterology, Beijing Hospital of Integrated Traditional Chinese and Western Medicine, Beijing 100039, China

Author contributions: Niu WC was responsible for data collection, microbiota sequencing analysis, and drafting of the manuscript; Wang SH contributed to clinical data acquisition, statistical analysis, and interpretation of the results; Niu WC and Wang SH contributed equally to this article, they are the co-first authors of this manuscript; Zhao Y conceptualized and supervised the study, critically revised the manuscript; and all authors read and approved the final manuscript.

Institutional review board statement: This study was approved by the Medical Ethics Committee of Beijing Hospital of Integrated Traditional Chinese and Western Medicine, approval No. KY2024-261-01.

Informed consent statement: Patient consent was waived due to the retrospective nature of the study and the use of anonymized clinical data, as approved by the Ethics Committee of Beijing Hospital of Integrated Traditional Chinese and Western Medicine.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Data sharing statement: The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

Corresponding author: Ye Zhao, Department of Gastroenterology, Beijing Hospital of Integrated Traditional Chinese and Western Medicine, No. 3 Yongding Road East Street, Haidian District, Beijing 100039, China. yezhao775822@163.com

Received: March 5, 2025
Revised: April 15, 2025
Accepted: May 23, 2025
Published online: July 27, 2025
Processing time: 140 Days and 4.1 Hours

Abstract

BACKGROUND

Endoscopic mucosa resection (EMR) is an important minimally invasive surgical method for treating early digestive tract tumors. In recent years, the crucial role of intestinal microbiota in disease occurrence and development has attracted increasing attention. However, the changes in intestinal microbiota after EMR and the effect of dietary fiber intervention on microbiota recovery remain insufficiently elucidated.

AIM

To investigate the effects of dietary fiber intervention on intestinal microbiota recovery in patients undergoing EMR and evaluate its potential to improve postoperative outcomes and intestinal microecological balance.

METHODS

This retrospective study analyzed intestinal microbiota sequencing and dietary fiber intervention in patients with EMR. Patients who underwent EMR surgery between 2020 and 2023 were selected and divided into a routine follow-up group and a dietary fiber intervention group. High-throughput 16S rRNA gene sequencing was performed to detect changes in patient intestinal microbiota, and microbiota diversity, structure, and function in different intervention groups were compared and analyzed.

RESULTS

A total of 86 patients with EMR were included in the study. Results showed that: (1) Intestinal microbiota diversity significantly decreased after EMR surgery, with notable changes in the proportion of Gram-negative bacilli and anaerobic bacteria; (2) The microbiota recovery rate in the dietary fiber intervention group was significantly higher than that in the control group, with a significantly higher microbiota diversity index (P < 0.05); and (3) The abundance of lactobacilli and bifidobacteria in the intervention group increased substantially, and intestinal barrier-related functional gene expression was upregulated.

CONCLUSION

Dietary fiber intervention can effectively promote intestinal microbiota recovery in patients with EMR, improve intestinal microecological balance, and provide a new intervention strategy for clinical post-EMR patient rehabilitation.

Keywords: Endoscopic mucosa resection; Intestinal microbiota; Dietary fiber; Microecology; Intervention study

Core Tip: Endoscopic mucosa resection (EMR) significantly alters intestinal microbiota, reducing diversity and disrupting microbial balance. This study demonstrates that dietary fiber intervention accelerates microbiota recovery, increases beneficial bacterial populations (lactobacilli and bifidobacteria), and enhances intestinal barrier function. Patients receiving dietary fiber supplementation exhibited lower inflammation, faster postoperative recovery, and improved long-term immune function. The findings highlight the critical role of dietary fiber in post-EMR rehabilitation, providing a novel strategy for optimizing intestinal microecology and clinical outcomes. Personalized dietary interventions should be integrated into post-EMR care to promote gut homeostasis and overall patient well-being.