Digestive Diseases and Sciences

, Volume 42, Issue 4, pp 738–742 | Cite as

Altered Small Bowel Motility in Patients with Liver Cirrhosis Depends on Severity of Liver Disease

  • Ana Maria Madrid
  • Francisco Cumsille
  • Carlos Defilippi


Abnormal small bowel motility has been describedin patients with liver cirrhosis but the mechanismsinvolved are unknown. The aim was to investigate apossible relationship between the severity of liver failure and the intensity of small intestinalabnormalities. Motility was studied during fasting, bymeans of perfused catheters and external transducers, on33 cirrhotics with different etiologies; 8 were at Child-Pugh stage A, 12 stage B, and 13 stageC. Both abnormalities of MMC and increased clusteredactivity were recorded. Absence of cycling activity wasmost frequently observed in Child-Pugh stage C patients compared to Child-Pugh stage Acirrhotics. A significant increase in clusteredcontractions from 4.7 ± 0.4/hr in stage Apatients to 11.3 ± 1.1 in stage C was recorded.The frequency and amplitude of contractions was also increased fromChild-Pugh stage A to stage C. Our findings might berelated to a delayed transit time observed in thesepatients and a higher prevalence of bacterial overgrowth in cirrhotics with more advanced liverdisease.



Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Chesta J, Defilippi C, Defilippi C: Abnormalities in proximal small bowel motility in patients with cirrhosis. Hepatology 17:828–832, 1993Google Scholar
  2. 2.
    Chesta J, Silva M, Thompson L, Del Canto E, Defilippi C: Small intestine bacterial overgrowth in patient with hepatic cirrhosis. Rev Med Chile 119:626–632, 1991Google Scholar
  3. 3.
    Chesta J, Generini G, Antezana C, Defilippi C: Are disturbances of small bowel motility in patients with liver cirrhosis related to hyperglucagonemia? Rev Med Chile 120:988–1002, 1992Google Scholar
  4. 4.
    Chesta J, Smok G: Myenteric plexuses of the small intestine in patients with liver cirrhosis: A histological study. Rev Med Chile 121:139–143, 1993Google Scholar
  5. 5.
    Christensen E, Schlichting P, Fauerholdt L, Glu C, Andersen PK, Juhl E, Poulsen H, Tygstrup N: Prognostic value of Child-Turcotte criteria in medically treated cirrhosis. Hepatology 3:430–435, 1984Google Scholar
  6. 6.
    Summers RW, Anuras S, Green J: Jejunal manometry patterns in health, partial intestinal obstruction, and pseudoobstruction. Gastroenterology 85:1290–1300, 1983Google Scholar
  7. 7.
    SAS Institute Inc: SAS/STAT User's Guide, Version, 4th ed., vol 1. Cary, North Carolina, SAS Inc, 1989, 943 ppGoogle Scholar
  8. 8.
    Johnson TJ, Quigley EMM, Adrian TE, Jin G, Pikkers LF: Glucagon, stress, and portal hypertension. Dig Dis Sci 40:1816–1823, 1995Google Scholar
  9. 9.
    Hendrickse MT, Thululath PJ, Triger DR: Natural history of automic neuropathy in chronic liver disease. Lancet 399:1462–1464, 1992Google Scholar
  10. 10.
    Reilly JA, Quigley EMM, Forst C, Rikkers LF: Small intestinal transit in the portal hypertensive rat. Gastroenterology 100:670–674, 1991Google Scholar
  11. 11.
    Van Thiel DH, Fagiuoli S, Wright HI, Chien MC, Gavaler JS: Gastrointestinal transit in cirrhotic patients: Effect of hepatic encephalopathy and its treatment. Hepatology 19:67–71, 1994Google Scholar
  12. 12.
    Chesta J, Lillo R, Defilippi C, Jouanne F, Massone MA, Maulen M, Zavala A: Mouth to caecum transit time and solid meal gastric emptying in patients with liver cirrhosis. Rev Med Chile 119:1284, 1991Google Scholar
  13. 13.
    Galati JS, Holdeman KP, Bottjen PL, Quigley EMM: Delayed small intestinal transit in chronic liver disease. Gastroenterology 106:A896, 1994Google Scholar
  14. 14.
    Lol D, Gorbach SL, Levitan R: Intestinal microflora in patients with alcoholic cirrhosis: Urea-splitting bacteria and neomycin resistance. Gastroenterology 62:275–279, 1972Google Scholar
  15. 15.
    Bade CH, Kolepke R, Schofer K, Babe JC: Hydrogen breath test in patients with alcoholic liver disease: Evidence for bacterial overgrowth. J Hepatol 11(suppl 2):S9, 1990Google Scholar
  16. 16.
    Casafont F, De las Heras G: Small bowel bacterial overgrowth in patients with alcoholic cirrhosis. Dig Dis Sci 40:1252–1256, 1995Google Scholar

Copyright information

© Plenum Publishing Corporation 1997

Authors and Affiliations

  • Ana Maria Madrid
  • Francisco Cumsille
  • Carlos Defilippi

There are no affiliations available

Personalised recommendations