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Small intestinal motility disturbances and bacterial overgrowth in patients with liver cirrhosis and portal hypertension.
Am J Gastroenterol 2003; 98(6):1362-70AJ

Abstract

OBJECTIVE

Altered small bowel motility and a high prevalence of small intestinal bacterial overgrowth (SIBO) has been observed in patients with liver cirrhosis. Our aim was to explore the relationship between motility abnormalities, portal hypertension, and SIBO.

METHODS

Twenty-four patients with liver cirrhosis were included. Twelve had portal hypertension (PH) and 12 had liver cirrhosis (LC) alone. Child-Pugh score was the same in the groups. Antroduodenojejunal pressure recordings were performed, and noninvasive variceal pressure measurements were undertaken. Thirty-two healthy volunteers served as a reference group. Bacterial cultures were obtained from jejunal aspirates.

RESULTS

The PH group had a higher proportion of individual pressure waves that were retrograde in the proximal duodenum during phase II (52% vs 13% vs 8% of propagated contractions; p < 0.001) as well as postprandially (49% vs 18% vs 13%; p < 0.01) compared with LC and controls, respectively. Long clusters were more common in PH than in controls (9.1 +/- 2.1 vs 4.9 +/- 0.8; p < 0.05), and a higher motility index in phase III in the proximal and distal duodenum was seen in the PH as compared with the other groups. The mean variceal pressure was 21 +/- 1 mm Hg. Motor abnormalities were not correlated to the level of variceal pressure. Thirty-three percent of the patients in the PH group but none in the LC group had SIBO.

CONCLUSIONS

Abnormal small bowel motility and SIBO is common in patients with liver cirrhosis with concomitant portal hypertension. Portal hypertension per se might be significantly related to small bowel abnormalities observed in patients with liver cirrhosis.

Authors+Show Affiliations

Department of Internal Medicine, Section of Gastroenterology and Hepatology, Sahlgrenska University Hospital, Göteborg, Sweden.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12818282

Citation

Gunnarsdottir, Steingerdur Anna, et al. "Small Intestinal Motility Disturbances and Bacterial Overgrowth in Patients With Liver Cirrhosis and Portal Hypertension." The American Journal of Gastroenterology, vol. 98, no. 6, 2003, pp. 1362-70.
Gunnarsdottir SA, Sadik R, Shev S, et al. Small intestinal motility disturbances and bacterial overgrowth in patients with liver cirrhosis and portal hypertension. Am J Gastroenterol. 2003;98(6):1362-70.
Gunnarsdottir, S. A., Sadik, R., Shev, S., Simrén, M., Sjövall, H., Stotzer, P. O., ... Björnsson, E. S. (2003). Small intestinal motility disturbances and bacterial overgrowth in patients with liver cirrhosis and portal hypertension. The American Journal of Gastroenterology, 98(6), pp. 1362-70.
Gunnarsdottir SA, et al. Small Intestinal Motility Disturbances and Bacterial Overgrowth in Patients With Liver Cirrhosis and Portal Hypertension. Am J Gastroenterol. 2003;98(6):1362-70. PubMed PMID: 12818282.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Small intestinal motility disturbances and bacterial overgrowth in patients with liver cirrhosis and portal hypertension. AU - Gunnarsdottir,Steingerdur Anna, AU - Sadik,Riadh, AU - Shev,Steven, AU - Simrén,Magnus, AU - Sjövall,Henrik, AU - Stotzer,Per Ove, AU - Abrahamsson,Hasse, AU - Olsson,Rolf, AU - Björnsson,Einar S, PY - 2003/6/24/pubmed PY - 2003/8/6/medline PY - 2003/6/24/entrez SP - 1362 EP - 70 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 98 IS - 6 N2 - OBJECTIVE: Altered small bowel motility and a high prevalence of small intestinal bacterial overgrowth (SIBO) has been observed in patients with liver cirrhosis. Our aim was to explore the relationship between motility abnormalities, portal hypertension, and SIBO. METHODS: Twenty-four patients with liver cirrhosis were included. Twelve had portal hypertension (PH) and 12 had liver cirrhosis (LC) alone. Child-Pugh score was the same in the groups. Antroduodenojejunal pressure recordings were performed, and noninvasive variceal pressure measurements were undertaken. Thirty-two healthy volunteers served as a reference group. Bacterial cultures were obtained from jejunal aspirates. RESULTS: The PH group had a higher proportion of individual pressure waves that were retrograde in the proximal duodenum during phase II (52% vs 13% vs 8% of propagated contractions; p < 0.001) as well as postprandially (49% vs 18% vs 13%; p < 0.01) compared with LC and controls, respectively. Long clusters were more common in PH than in controls (9.1 +/- 2.1 vs 4.9 +/- 0.8; p < 0.05), and a higher motility index in phase III in the proximal and distal duodenum was seen in the PH as compared with the other groups. The mean variceal pressure was 21 +/- 1 mm Hg. Motor abnormalities were not correlated to the level of variceal pressure. Thirty-three percent of the patients in the PH group but none in the LC group had SIBO. CONCLUSIONS: Abnormal small bowel motility and SIBO is common in patients with liver cirrhosis with concomitant portal hypertension. Portal hypertension per se might be significantly related to small bowel abnormalities observed in patients with liver cirrhosis. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/12818282/Small_intestinal_motility_disturbances_and_bacterial_overgrowth_in_patients_with_liver_cirrhosis_and_portal_hypertension_ L2 - http://Insights.ovid.com/pubmed?pmid=12818282 DB - PRIME DP - Unbound Medicine ER -