Small bowel bacterial overgrowth in patients with alcoholic cirrhosis
- 86 Downloads
A total of 89 patients with alcoholic cirrhosis and 40 healthy subjects were included in a study to assess the prevalence of intestinal bacterial overgrowth and to analyze its relationship with the severity of liver dysfunction, presence of ascites, and development of spontaneous bacterial peritonitis (SBP). Bacterial overgrowth was measured by means of a breath test after ingestion of glucose. Intestinal bacterial overgrowth was documented in 27 (30.3%) of the 89 patients with alcoholic cirrhosis and in none of the healthy subjects. The prevalence of intestinal bacterial overgrowth was significantly higher in cirrhotics with ascites (37.1%) than in those with no evidence of ascites (5.3%) and among patients with Pugh-Child class C (48.3%) than in patients with class A (13.1%) or B (27%). Twelve (17.1%) of the 70 patients with ascites developed an episode of SBP. The prevalence of spontaneous bacterial peritonitis was significantly higher in patients who had intestinal bacterial overgrowth (30.7%) than in patients who did not (9.09%). We conclude that intestinal bacterial overgrowth occurs in approximately one third of patients with cirrhosis secondary to alcohol, particularly in patients with ascites and advanced liver dysfunction. Moreover, bacterial overgrowth may be a condition favoring infection of the ascitic fluid.
Key wordsalcoholic liver cirrhosis intestinal bacterial overgrowth bacterial translocation ascites spontaneous bacterial peritonitis
Unable to display preview. Download preview PDF.
- 2.Deitch EA, Berg R: Bacterial translocation from the gut: A mechanism of infection. J Burn Care Rehab 8:475–482, 1987Google Scholar
- 3.Bode J, Bode C, Heidelbach R, Durr HK, Martini GA: Jejunal microflora in patients with chronic alcohol abuse. Hepatogastroenterol 31:30–34, 1984Google Scholar
- 5.Bode CH, Kolepke K, Schäfer K, Bode JCh: Hydrogen breath test in patients with alcoholic liver disease: Evidence for bacterial overgrowth in the small intestine. J Hepatol 11:S9, 1990 (abstract)Google Scholar
- 6.Potela-Gomes G, Pinto-Correia J, Dantas R, Pires IR, Laranjeira MR, Figuereido A: Jejunal microflora in patients with liver cirrhosis. Arq Gastroenterol (Sao Paulo) 14:72–75, 1977Google Scholar
- 7.Baraona E, Julkunen R, Tannenbaum L, Lieber CS: Role of intestinal bacterial overgrowth in ethanol production and metabolism in rats. Gastroenterology 90:13–100, 1986Google Scholar
- 15.Reilly JA Jr, Quigley EMM, Forst CF, Rikkers LF: Small intestinal transit in the portal hypertensive rat. Gastroenterology 100:6700–674, 1991Google Scholar
- 17.Scott LD, Summers RW: Effect of glucagon and caerulein on propulsion and motility in the rat small intestine. Gastroenterology 66:A-120/774, 1974 (abstract)Google Scholar
- 18.Inou F, Frank GB: Effects of ethyl alcohol on excitability and on neuromuscular transmission in frog skeletal muscle. Br J Pharmcol Chemother 30:186–193, 1967Google Scholar
- 32.Llovet JM, Bartoli R, Planas R, Arnal J, Cabre E, Urban A: Relación de la traslocación bacteriana (TB) con la peritonitis bacteriana espontánea (PE) en ratas cirróticas. Gastroenterol Hepatol 16:269–270, 1993 (abstract)Google Scholar