Impairment of intestinal mucosa composition in mechanisms of intestinal dysfunction development in patients with hepatic cirrhosis
- Authors: Yakovenko E.P.1, Kagramanova A.V.1, Yakovenko A.V.1, Ivanov A.N.1, Agafonova N.A.1, Obukhovskiy B.I.1, Gioeva I.Z.1, Pryanishnikova A.S.1, Yakovenko EP2, Kagramanova AV2, Yakovenko AV2, Ivanov AN2, Agafonova NA2, Obukhovsky BI2, Gioeva IZ2, Pryanishnikova AS2
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Affiliations:
- N.I. Pirogov State Medical University, Moscow
- Issue: Vol 84, No 2 (2012)
- Pages: 41-45
- Section: Editorial
- URL: https://ter-arkhiv.ru/0040-3660/article/view/30991
- ID: 30991
Cite item
Full Text
Abstract
Material and methods. Endoscopic and morphological examinations of duodenal and colon mucosa were performed in 160 patients with viral HC and portal hypertension (PH) taking consideration of the presence of portal chypertensive duodeno- and colonopathy. Intestinal microflora was studied with lactulose respiration hydrogen test, bacteriological examination of the feces was also made. Clinical manifestations of intestinal dyspepcia were analysed as in irritable colon syndrome (ICS). The following disturbances were recognized: diarrhea, constipation, mixed, syndrome of duodenal hypertension.
Results. Most of HC patients suffered from disturbed intestinal microflora composition, 46,3 % had bacterial overgrowth in the small intestine, 38 (23,8 %) - isolated impairment of colon microflora. Structural changes of intestinal mucosa associated with HC were found in 80% patients. Abnormal intestinal biocenosis occurred more often in patients with portal hypertensive duodeno- and colonopathy. ICS-like disorders were detected in 80,4 % patients with abnormal intestinal biocenosis, 33,1 % - had symptoms characteristic of duodenal hypertension.
Conclusion. In HC patients intestinal dysbiosis is an essential pathogenetic factor of formation of intestinal dyspeptic syndrome. Detection of portal hypertensive dyodenopathy and/or colonopathy in HC patients is a definite risk factor of impairment of normal composition of intestinal microflora.
About the authors
Emiliya Prokhorovna Yakovenko
Email: epya_1940@mail.ru
Anna Valer'evna Kagramanova
Andrey Vladislavovich Yakovenko
Aleksandr Nikolaevich Ivanov
Natal'ya Anatol'evna Agafonova
Boris Ivanovich Obukhovskiy
Irina Zaurbekovna Gioeva
Antonina Semenovna Pryanishnikova
E P Yakovenko
N.I. Pirogov State Medical University, MoscowN.I. Pirogov State Medical University, Moscow
A V Kagramanova
N.I. Pirogov State Medical University, MoscowN.I. Pirogov State Medical University, Moscow
A V Yakovenko
N.I. Pirogov State Medical University, MoscowN.I. Pirogov State Medical University, Moscow
A N Ivanov
N.I. Pirogov State Medical University, MoscowN.I. Pirogov State Medical University, Moscow
N A Agafonova
N.I. Pirogov State Medical University, MoscowN.I. Pirogov State Medical University, Moscow
B I Obukhovsky
N.I. Pirogov State Medical University, MoscowN.I. Pirogov State Medical University, Moscow
I Z Gioeva
N.I. Pirogov State Medical University, MoscowN.I. Pirogov State Medical University, Moscow
A S Pryanishnikova
N.I. Pirogov State Medical University, MoscowN.I. Pirogov State Medical University, Moscow
References
- Шерлок Ш., Дули Д. Заболевания печени и желчных путей: Практ. руководство: Пер. с англ. под ред. З. Г. Апросиной, И. А. Мухина. М: Гэотар-медиа; 1999.
- Bauer T. M., Schwacha H., Steinbruckner B. et al. Small intestinal bacterial overgrowth in human cirrhosis is associated with systemic endotoxaemia. Am. J. Gastroenterol. 2002; 97: 2364-2370.
- Almeida J., Galhenage S., Yu J. et al. Gut flora and bacterial translocation in chronic liver disease. Wld J. Gastroenterol. 2006; 12 (10): 1493-1502.
- Alexander J. W., Boyce S. T., Babcock G. F. et al. The process of microbial translocation. Ann. Surg. 1990; 212: 496-512.
- Rondonotti E., Villa F., Signorelli C., Franchis R. Portal hypertensive enteropathy. Gastrointest. Endoscopy Clin. N. Am. 2006; 16: 277-286.
- Нashimoto N., Ohyanagi H. Effect of acute portal hypertension on gut mucosa. Hepatogastroenterology 2002; 49: 1567-1570.
- Farrokhyar F., Marshall J. K., Easterbrook B. et al. Functional gastrointestinal disorders and mood disorders in patients with inactive inflammatory bowel disease: Prevalence and impact on health. Inflamm. Bowel Dis. 2006; 12 (1): 38-45.
- McCormac T. T., Sims J., Eyre-Brook I. et al. Gastric lesions in portal hypertension;inflamatory gastritis or congestive gastropathy? Gut 1985; 26: 1226-1232.
- Каграманова А. В., Яковенко А. В., Балицкий Е. В. Портальная гипертензионная колонопатия у больных циррозом печени: клинико-морфологическое исследование. Изв. высш. учебн. заведений. Северо-Кавказ. регион. Естеств. науки 2010; 3: 117-121.
- Walters B., Vanner S. J. Detection of bacterial overgrowth in IBS using the lactulose H2 breath test: comparison with 14C-Dxylose and healthy controls. Am. J. Gastroenterol. 2005; 100: 1566-1570.
- Парфенов А. И. Энтерология. М.: Триада, 2000.
- Яковенко А. В., Яковенко Э. П. Цирроз печени: вопросы терапии. Consilium Medicum 2006; 8: 17-21.
