Document Detail

Small intestinal motility disturbances and bacterial overgrowth in patients with liver cirrhosis and portal hypertension.
MedLine Citation:
PMID:  12818282     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Altered small bowel motility and a high prevalence of small intestinal bacterial overgrowth (SIBO) has been observed in patients with liver cirrhosis. Our aim was to explore the relationship between motility abnormalities, portal hypertension, and SIBO. METHODS: Twenty-four patients with liver cirrhosis were included. Twelve had portal hypertension (PH) and 12 had liver cirrhosis (LC) alone. Child-Pugh score was the same in the groups. Antroduodenojejunal pressure recordings were performed, and noninvasive variceal pressure measurements were undertaken. Thirty-two healthy volunteers served as a reference group. Bacterial cultures were obtained from jejunal aspirates. RESULTS: The PH group had a higher proportion of individual pressure waves that were retrograde in the proximal duodenum during phase II (52% vs 13% vs 8% of propagated contractions; p < 0.001) as well as postprandially (49% vs 18% vs 13%; p < 0.01) compared with LC and controls, respectively. Long clusters were more common in PH than in controls (9.1 +/- 2.1 vs 4.9 +/- 0.8; p < 0.05), and a higher motility index in phase III in the proximal and distal duodenum was seen in the PH as compared with the other groups. The mean variceal pressure was 21 +/- 1 mm Hg. Motor abnormalities were not correlated to the level of variceal pressure. Thirty-three percent of the patients in the PH group but none in the LC group had SIBO. CONCLUSIONS: Abnormal small bowel motility and SIBO is common in patients with liver cirrhosis with concomitant portal hypertension. Portal hypertension per se might be significantly related to small bowel abnormalities observed in patients with liver cirrhosis.
Steingerdur Anna Gunnarsdottir; Riadh Sadik; Steven Shev; Magnus Simrén; Henrik Sjövall; Per Ove Stotzer; Hasse Abrahamsson; Rolf Olsson; Einar S Björnsson
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  98     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-06-23     Completed Date:  2003-08-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1362-70     Citation Subset:  IM    
Department of Internal Medicine, Section of Gastroenterology and Hepatology, Sahlgrenska University Hospital, Göteborg, Sweden.
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MeSH Terms
Bacterial Infections / physiopathology*
Esophageal and Gastric Varices / microbiology,  physiopathology
Gastrointestinal Motility / physiology*
Hypertension, Portal / microbiology*,  physiopathology*
Intestinal Diseases / microbiology,  physiopathology*
Jejunum / microbiology,  physiology
Liver Cirrhosis / microbiology*,  physiopathology*
Middle Aged

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