The role of intestinal microflora in the development of cholelithiasis (literature review)

Abstract

Cholelithiasis is one of the most common diseases of the digestive system, which affects all segments of the population. Currently, cholelithiasis is considered as a long, multi-stage process in which the period of stone formation is preceded by changes in metabolism and physical and chemical properties of bile. However, among the many contributing factors, insufficient attention is paid to the role of the infectious factor in the development of cholelithiasis. The analysis of the literature data showed that today there are various mechanisms for promoting ob development of cholelithiasis by excess enteral bacterial grouth. First, with excessive bacterial growth, duodeno-biliary reflux leads to infection of the biliary tract and the development of inflammation in the gallbladder. Substances that occur during the inflammatory process (proteins, mucus, exfoliated epithelium) are the matrix on which the gallstone is formed. Secondly, the role of dysbiosis in violation of enterohepatic circulation of bile acids is essential. The change in the ratio of conjugated and deconjugated bile acids contributes to the formation of lithogenic bile. Third, excessive bacterial growth leads to endotoxemia, which has a damaging effect on the metabolism of bile acids in the liver. Finally, in a certain dependence on the microbiota is the digestive and suction functions of the small intestine, but the participation of this channel in cholelithiasis requires further research.

Keywords

• gallstone disease
• enterohepatic circulation of bile acids
• excessive bacterial growth
• intestinal arrhythmia
• endotoxinemia