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Gastrointestinal dysfunction in liver cirrhosis.

Abstract

Patients with liver cirrhosis exhibit several features of gut dysfunction which may contribute to the development of cirrhosis complications as well as have an impact on nutritional status and health-related quality of life. Gastrointestinal symptoms are common in cirrhosis and their pathophysiology probably involves factors related to liver disease severity, psychological distress, and gut dysfunction (e.g., increased gastric sensitivity to distension and delayed gut transit). They may lead to reduced food intake and, thus, may contribute to the nutritional status deterioration in cirrhotic patients. Although tense ascites appears to have a negative impact on meal-induced accommodation of the stomach, published data on gastric accommodation in cirrhotics without significant ascites are not unanimous. Gastric emptying and small bowel transit have generally been shown to be prolonged. This may be related to disturbances in postprandial glucose, insulin, and ghrelin levels, which, in turn, appear to be associated to insulin resistance, a common finding in cirrhosis. Furthermore, small bowel manometry disturbances and delayed gut transit may be associated with the development of small bowel bacterial overgrowth. Finally, several studies have reported intestinal barrier dysfunction in patients with cirrhosis (especially those with portal hypertension), which is related to bacterial translocation and permeation of intestinal bacterial products, e.g., endotoxin and bacterial DNA, thus potentially being involved in the pathogenesis of complications of liver cirrhosis.

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  • Authors+Show Affiliations

    Evangelos Kalaitzakis, Department of Gastroenterology, Skåne University Hospital, University of Lund, 22185 Lund, Sweden.

    Source

    World journal of gastroenterology 20:40 2014 Oct 28 pg 14686-95

    MeSH

    Animals
    Bacterial Translocation
    Enteric Nervous System
    Gastrointestinal Diseases
    Gastrointestinal Motility
    Gastrointestinal Tract
    Humans
    Liver Cirrhosis
    Malnutrition
    Nutritional Status
    Permeability
    Prognosis
    Risk Factors

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    25356031

    Citation

    Kalaitzakis, Evangelos. "Gastrointestinal Dysfunction in Liver Cirrhosis." World Journal of Gastroenterology, vol. 20, no. 40, 2014, pp. 14686-95.
    Kalaitzakis E. Gastrointestinal dysfunction in liver cirrhosis. World J Gastroenterol. 2014;20(40):14686-95.
    Kalaitzakis, E. (2014). Gastrointestinal dysfunction in liver cirrhosis. World Journal of Gastroenterology, 20(40), pp. 14686-95. doi:10.3748/wjg.v20.i40.14686.
    Kalaitzakis E. Gastrointestinal Dysfunction in Liver Cirrhosis. World J Gastroenterol. 2014 Oct 28;20(40):14686-95. PubMed PMID: 25356031.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Gastrointestinal dysfunction in liver cirrhosis. A1 - Kalaitzakis,Evangelos, PY - 2013/10/25/received PY - 2014/04/27/revised PY - 2014/06/02/accepted PY - 2014/10/31/entrez PY - 2014/10/31/pubmed PY - 2015/8/11/medline KW - Gastric accommodation KW - Gastrointestinal symptoms KW - Gut motility KW - Intestinal permeability KW - Liver cirrhosis KW - Malnutrition SP - 14686 EP - 95 JF - World journal of gastroenterology JO - World J. Gastroenterol. VL - 20 IS - 40 N2 - Patients with liver cirrhosis exhibit several features of gut dysfunction which may contribute to the development of cirrhosis complications as well as have an impact on nutritional status and health-related quality of life. Gastrointestinal symptoms are common in cirrhosis and their pathophysiology probably involves factors related to liver disease severity, psychological distress, and gut dysfunction (e.g., increased gastric sensitivity to distension and delayed gut transit). They may lead to reduced food intake and, thus, may contribute to the nutritional status deterioration in cirrhotic patients. Although tense ascites appears to have a negative impact on meal-induced accommodation of the stomach, published data on gastric accommodation in cirrhotics without significant ascites are not unanimous. Gastric emptying and small bowel transit have generally been shown to be prolonged. This may be related to disturbances in postprandial glucose, insulin, and ghrelin levels, which, in turn, appear to be associated to insulin resistance, a common finding in cirrhosis. Furthermore, small bowel manometry disturbances and delayed gut transit may be associated with the development of small bowel bacterial overgrowth. Finally, several studies have reported intestinal barrier dysfunction in patients with cirrhosis (especially those with portal hypertension), which is related to bacterial translocation and permeation of intestinal bacterial products, e.g., endotoxin and bacterial DNA, thus potentially being involved in the pathogenesis of complications of liver cirrhosis. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/25356031/full_citation L2 - http://www.wjgnet.com/1007-9327/full/v20/i40/14686.htm DB - PRIME DP - Unbound Medicine ER -