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Bacterial Translocation and Alterations of the Digestive System

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Chronic Liver Failure

Part of the book series: Clinical Gastroenterology ((CG))

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Abstract

The intimate interrelation between gastrointestinal tract and liver is characterized by the unique anatomic position of both tissues using the portal vein as a private channel. Therefore, not surprisingly, chronic liver failure induces many changes in the gastrointestinal tract, and gastrointestinal symptoms are common in patients with liver cirrhosis and portal hypertension. In addition, translocation of bacteria and bacterial products from the gut along with concomitant release of proinflammatory mediators are a pathophysiological hallmark in the course of disease. This chapter tries to delineate the multiple different mechanisms involved in the process of bacterial translocation in liver cirrhosis highlighting alterations in intestinal flora and mucosal barrier function as well as particularly emphasizing immunological aspects. Moreover, the current available data regarding potential consequences that may derive from increased “pathological” BT are discussed. Finally, macro- and microscopic changes and functional alterations observed in the digestive tract in chronic liver failure contributing to bleeding complications, hypermetabolism, catabolism, malnutrition, and thus increased morbidity and mortality are summarized.

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  1. Department of Internal Medicine, University of Regensberg, Regensberg, Germany

    Reiner Wiest

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  1. Liver Unit, Hospital Clinic, University of Barcelona, Villarroel 170, Barcelona, 08036, Spain

    Pere Ginès

  2. College of Medicine, Division of Gastroenterology and Hepatol, Mayo Clinic, 200 First St. S.W, Rochester, 55905, Minnesota, USA

    Patrick S. Kamath

  3. Liver Unit, Hospital Clinic, University of Barcelona, Barcelona, 08036, Spain

    Vicente Arroyo

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Wiest, R. (2011). Bacterial Translocation and Alterations of the Digestive System. In: Ginès, P., Kamath, P., Arroyo, V. (eds) Chronic Liver Failure. Clinical Gastroenterology. Humana Press. https://doi.org/10.1007/978-1-60761-866-9_10

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