A correlation between gastrointestinal dysfunction and cirrhosis severity

Abstract

This study aims to investigate the relationship between gastrointestinal dysfunction (GD) and cirrhosis severity in cirrhotic patients, to provide evidences for the prevention and treatment of GD in cirrhotic patients.A total of 95 cirrhotic inpatients and outpatients, who were treated in the Department of Gastroenterology of Xinqu Hospital of the First Affiliated Hospital of Henan University of Science and Technology, were enrolled in the present study, and assigned as the experimental group (cirrhosis group). According to Child–Pugh classification, these patients were divided into 3 groups: group A (n = 45), group B (n = 23), and group C (n = 27). Forty healthy adults who received health check-ups during the same period served as the control group. The gastrointestinal (GI) symptoms of cirrhotic patients were scored, and the fasting serum gastrin (GAS), motilin (MTL), and vasoactive intestinal peptide (VIP) levels were measured in all subjects.The potential correlations of GI symptom scores of patients in these cirrhosis groups with GI hormone levels and cirrhosis severity were analyzed. In cirrhotic patients, the GI symptom scores significantly increased. Furthermore, the symptom scores gradually increased along with the aggravation of liver damage. Moreover, serum GAS and VIP levels were significantly higher in the cirrhosis groups than in the control group, whereas MTL levels were significantly lower. These changes were significantly correlated with cirrhosis severity. The linear correlation analysis revealed that the GI symptom score was positively correlated with GAS and VIP levels, and negatively correlated with MTL level. In addition, the linear correlation analysis revealed that GI symptom score and GAS and VIP levels were positively correlated with cirrhosis severity, whereas MTL level was negatively correlated with cirrhosis severity.Cirrhotic patients have more obvious GI symptoms and higher GI hormone levels, which are closely correlated with the progression of liver cirrhosis and the degree of liver function damage.

Profil Pemeriksaan Hematologi dan Fungsi Hati pada Lansia dengan Sirosis Hepatis

“…Pemeriksaan penunjang laboratorium diperlukan untuk memantau perkembangan penyakit dan melihat tingkat keparahan pada sirosis hati seperti pemeriksaan hematologi (hemoglobin (Hb), leukosit, hematokrit (Ht) dan trombosit) dan pemeriksaan fungsi hati (AST, ALT dan albumin), terutama pada pasien lansia untuk menghindari risiko komplikasi yang lebih parah (7,8). Penelitian yang sudah ada tidak khusus mengambil pada kelompok usia lanjut, berdasarkan hal tersebut, penulis ingin melihat karakteristik dan profil pemeriksaan hematologi (Hb, leukosit, Ht, trombosit) dan fungsi hati (AST, ALT dan albumin) pada pasien lansia sirosis hati di Rumah Sakit Islam Jakarta Sukapura periode 2016 -2022.…”

“…Gejala klinis pasien sirosis hati pada penelitian ini terbanyak adalah mual sebanyak 78,1% dan muntah 43,8%, penelitian ini sejalan dengan penelitian Frijo Jose et al, (2020) di India yang menyatakan bahwa sirosis hati dapat mengalami gejala gastrointestinal yaitu mual dan muntah (31%). Kerusakan sel hati dapat menyebabkan aktivasi pusat muntah yang merangsang saluran cerna untuk mendorong isi lambung dan menyebabkan mual dan muntah, mual muntah juga dapat terjadi karena asites menekan lambung sehingga merangsang pusat muntah (8). Selain gejala tersebut terdapat pula gejala penurunan nafsu makan, peradangan sistematis menginduksi berbagai mediator termasuk sitokin pro-inflamasi seperti IL-1 dan stimulan yang melepaskan sitokin yang mengurangi jumlah dan frekuensi asupan makanan (9).…”

“…Gejala klinis lain yaitu nyeri perut dan perut penuh, hal ini dapat terjadi akibat hepatomegali atau splenomegali yang mendesak organ intraabdomen kemudian merangsang nosiseptor nyeri di hepar dan persepsi nyeri di perut kanan atas (8).…”

Perbedaan Rerata Kadar Albumin Serum Berdasarkan Klasifikasi Child Turcotte Pugh pada Pasien Sirosis Hepatis di RSUP Dr. M. Djamil Padang

“…11 Komplikasi yang dapat ditimbulkan akibat sirosis hepatis, yaitu asites, ruptur varises esofagus, sindrom hepatorenal, peritonitis bakterial spontan dan splenomegali. 12 Pasien sirosis hepatis dapat mengalami hipersplenisme. 13 Hepatocelular Carcinoma (HCC) merupakan tumor yang sering ditemukan pada pasien sirosis hepatis.…”

Physiologically Based Pharmacokinetic/Pharmacodynamic Modeling to Support Waivers of In Vivo Clinical Studies: Current Status, Challenges, and Opportunities

“…Briefly, further research is required to shed light on the altered physiology (and ontogeny) of the GI tract and dosage form interactions with physiological variables in pediatric, elderly, and obese populations, patients with celiac disease, ulcerative colitis or Crohn’s disease, cirrhotic, diabetic, bariatric surgery, Parkinson’s and nonalcoholic fatty liver disease patients. Very few reports on these matters are available in the literature. − Similarly, the complete picture of the consequences of chronic administration of ARA/PPIs on GI physiology, oral absorption, and DDIs, especially in oncology patients, is also lacking. , The same holds true for the availability of tools and current knowledge on food effects in specific populations. , Effects of age, disease, race, or ethnicity in intestinal permeability and gut wall metabolism are only partly understood. In addition, reports have associated the decreased bioavailability of mizoribine in healthy Japanese subjects with polymorphisms on the concentrative nucleoside transporter 1 ( SLC28A1 ) .…”