Polyethylene glycol-based bowel preparation and gut dysbiosis: Clinical implications beyond colon cleansing

doi:10.3748/wjg.118836

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World Journal of Gastroenterology

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1007-9327

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

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Sep 21, 2026; 32(35): 118836
Published online Sep 21, 2026. doi: 10.3748/wjg.118836

Table 2 Strategies to mitigate polyethylene glycol-associated dysbiosis while preserving bowel cleansing efficacy

Strategy	Proposed mechanism	Potential benefit	Current evidence
Split-dose PEG[58]	Reduced continuous osmotic stress	Faster microbiota recovery	Clinical
Low-volume PEG formulations[58]	Lower luminal osmotic burden	Reduced ecological disruption	Emerging clinical
Probiotics[54-57]	Restoration of microbial balance	Reduced GI symptoms and faster recovery	Clinical + meta-analysis
Prebiotic/fiber-enriched diets[53]	Support of SCFA-producing bacteria	Enhanced microbial resilience	Clinical observational
Butyrate/glutamine supplementation[59,60]	Barrier protection and epithelial repair	Reduced permeability and inflammation	Experimental

PEG: Polyethylene glycol; GI: Gastrointestinal; SCFA: Short-chain fatty acid.

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Citation: Melgaço ACC, Alves AF, Pessoa WFB. Polyethylene glycol-based bowel preparation and gut dysbiosis: Clinical implications beyond colon cleansing. World J Gastroenterol 2026; 32(35): 118836
URL: https://www.wjgnet.com/1007-9327/full/v32/i35/118836.htm
DOI: https://dx.doi.org/10.3748/wjg.118836

Melgaço ACC, Alves AF, Pessoa WFB. Polyethylene glycol-based bowel preparation and gut dysbiosis: Clinical implications beyond colon cleansing. World J Gastroenterol 2026; 32(35): 118836 [DOI: 10.3748/wjg.118836]

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