Changes in bowel-movement frequency, gut microbiota, and emotional issues in postoperative constipation patients.

BACKGROUND

In recent years, the prevalence of chronic constipation among adults worldwide has shown a yearly increasing trend, with most patients experiencing varying degrees of emotional disorders. Understanding the underlying mechanisms linking chronic constipation, gut microbiota, and emotional status is crucial for developing effective therapeutic strategies.

OBJECTIVES

To investigate the clinical efficacy of surgical intervention for slow-transit constipation and evaluate its postoperative impacts on bowel function, gut microbiota composition and function, and host immune status.

METHODS

This study aimed to explore the relationship between gut microbiota and emotional status by collecting preoperative and postoperative clinical data, psychological conditions, and gut microbiota profiles from 30 patients undergoing total colectomy with ileorectal anastomosis for chronic constipation. Clinical and microbiota data were analysed to evaluate changes in emotional status and gut microbiota composition before and after surgery.

RESULTS

The results demonstrated that the anxiety and depression levels of patients significantly improved following surgery. Concurrently, gut microbiota diversity noticeably decreased, accompanied by significant alterations in species composition. Postoperative changes revealed that Clostridium sensu stricto and Streptococcus were key species contributing to the differences observed between preoperative and postoperative microbiota profiles. Notably, Streptococcus was negatively correlated with emotional symptoms such as obsession, anxiety, and depression, and positively correlated with the lactose and galactose degradation pathway.

CONCLUSIONS

This study suggests that constipation surgery not only improves bowel movements, but also alters the composition of gut microbiota and ameliorates mood disorders in patients. These findings provide novel insights into the interplay between gut microbiota and emotional well-being, highlighting the potential of targeting gut microbiota as a therapeutic approach for managing psychological conditions associated with chronic constipation.