Assessing Knowledge, Attitudes, and Practices of Gut Microbiome Counseling Among Colorectal Surgeons

Abstract

particularly in colorectal surgery. Despite growing evidence supporting microbiome modulation in clinical practice, little is known about colorectal surgeons' knowledge, attitudes, and practices (KAP) regarding gut microbiome counseling. This study aimed to assess colorectal surgeons’ awareness and integration of microbiome-related counseling in patient management.

Methods: A cross-sectional descriptive study was conducted among 150 colorectal surgeons across multiple hospitals and surgical centers. Participants were recruited using a nonrandomized convenience sampling method. Data were collected via a structured, self-administered questionnaire, assessing: Demographic and professional characteristics, Knowledge of the gut microbiome and its clinical implications, Attitudes toward gut microbiome counseling and Current practices related to microbiome counseling Statistical analysis was performed using SPSS version 26, including descriptive statistics, chi-square tests, and multiple linear regression to determine associations between demographic variables and KAP scores.

Results: Among the 150 colorectal surgeons, 72.7% were male, and 44.7% were aged 40–49 years. Overall, 43.3% demonstrated good knowledge of gut microbiota, while 39.3% had average knowledge, and 17.3% exhibited poor knowledge. Only

54.0% were aware of probiotics’ role in postoperative infection prevention.

Regarding attitudes, 44.0% of participants maintained a neutral stance on microbiome counseling, while 28.0% held a positive attitude, and 28.0% had a negative attitude. In terms of clinical practices, only 41.3% of surgeons routinely discussed gut microbiota with patients, and 35.3% recommended probiotics after antibiotic use. Public hospital surgeons were more likely to recommend probiotics (p = 0.03), and prior microbiome training was significantly associated with higher knowledge scores (p = 0.002).

Conclusion: This study reveals substantial gaps in knowledge, attitudes, and practices regarding gut microbiome counseling among colorectal surgeons. Although many surgeons recognize the importance of microbiota, this awareness is not consistently reflected in clinical practice. The findings highlight the need for targeted microbiome-related education and training to improve surgeons' confidence in patient counseling. Integrating microbiome-focused continuing medical education (CME) programs and updated clinical guidelines could enhance patient care by promoting microbiome-informed surgical decision-making.