Impairment of intestinal mucosa composition in mechanisms of intestinal dysfunction development in patients with hepatic cirrhosis

Abstract

Aim. To investigate the role of intestinal microflora impairment in development of clinical manifestations of intestinal dyspepsia in patients with hepatic cirrhosis (HC). 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.

Keywords

• hepatic cirrhosis
• portal hypertensive duodenopathy
• portal hypertensive colonopathy
• bacterial overgrowth in the small intestine
• ics-like disorders