Compound polyethylene glycol electrolyte powder-based bowel preparation protects the intestinal barrier: A retrospective controlled study

Abstract: Background: Preoperative bowel preparation is a crucial perioperative step in gastrointestinal surgery. Traditional mannitol combined with soap enema regimens can easily damage the intestinal mucosa and disrupt the intestinal barrier. Compound polyethylene glycol electrolyte powder (PGEP) has the potential to protect the intestinal barrier; however, multidimensional clinical evidence remains limited. Objectives: From the perspective of intestinal barrier protection, this study compares the effects of PGEP and traditional regimens in elective gastrointestinal surgery, analyzing their influence on the intestinal barrier, microecology, stress, intestinal function and anastomotic healing. Methods: In this retrospective controlled study, 100 patients undergoing elective surgery at the Department of Gastrointestinal Surgery, Wenzhou Central Hospital, from June 2021 to June 2024 were allocated into an observation group (PGEP group, n=50;28 males, 22 females) and a control group (traditional regimen group, n=50;26 males, 24 females;) Patients were assigned to groups according to the bowel preparation regimen used in routine clinical practice. Relevant laboratory indicators were measured and clinical outcomes were recorded. Results: The primary endpoint, serum diamine oxidase (DAO) level on the 1st day after surgery, was significantly lower in the observation group than in the control group (p < 0.05). For the secondary endpoints, the observation group also showed superior bowel preparation quality (assessed by BBPS), better preservation of intestinal barrier function, greater gut microbiota stability (higher fecal short-chain fatty acids and more stable pH), a reduced stress response, faster recovery of intestinal function, reduced anastomotic edema, a higher primary healing rate and a lower overall postoperative complication rate (all p < 0.05). Conclusion: PGEP is clinically superior to traditional methods for preoperative bowel preparation in elective gastrointestinal surgeries. It effectively protects the intestinal mucosal barrier, stabilizes the gut microbiota and reduces stress, aligning with the principles of enhanced recovery after surgery (ERAS) and these results suggest potential clinical value.