Decompensated Cirrhotics Have Slower Intestinal Transit Times as Compared With Compensated Cirrhotics and Healthy Controls

Roland, Bani Chander; García–Tsao, Guadalupe; Ciarleglio, Maria; Deng, Yanhong; Sheth, Anish A.

doi:10.1097/mcg.0b013e31829006bb

Cited by 39 publications

(28 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Three studies investigated small intestinal motility, in particular motility of the proximal small intestine, by recording migrating motor complex (MMC) activity using manometric catheters inserted into the proximal small intestine ( n = 74) [43–45]. A single study used a wireless motility capsule (SmartPill) ( n = 20) [46]. The most common documented abnormality was prolonged phase 2 occupied by multiple-clustered contractions.…”

Section: Small Intestinal Motilitymentioning

confidence: 99%

Gastrointestinal Motility Disorders and Their Clinical Implications in Cirrhosis

Theocharidou

Dhar

Patch

2017

Gastroenterology Research and Practice

View full text Add to dashboard Cite

Gastrointestinal motility is impaired in a substantial proportion of patients with cirrhosis. Cirrhosis-related autonomic neuropathy, increased nitric oxide production, and gut hormonal changes have been implicated. Oesophageal dysmotility has been associated with increased frequency of abnormal gastro-oesophageal reflux. Impaired gastric emptying and accommodation may result in early satiety and may have an impact on the nutritional status of these patients. Small intestinal dysmotility might be implicated in small intestinal bacterial overgrowth and increased bacterial translocation. The latter has been implicated in the pathophysiology of hepatic encephalopathy and spontaneous bacterial peritonitis. Enhanced colonic motility is usually associated with the use of lactulose. Pharmacological interventions aiming to alter gastrointestinal motility in cirrhosis could potentially have a beneficial effect reducing the risk of hepatic decompensation and improving prognosis.

show abstract

Section: Small Intestinal Motilitymentioning

confidence: 99%

Gastrointestinal Motility Disorders and Their Clinical Implications in Cirrhosis

Theocharidou

Dhar

Patch

2017

Gastroenterology Research and Practice

View full text Add to dashboard Cite

show abstract

“…Patients with decompensated cirrhosis have a slower transit time compared with patients with compensated cirrhosis and healthy individuals 50. Moreover, some prokinetic drugs such as cisapride have been shown to decrease bacterial trans-location and overgrowth in cirrhotic patients 11.…”

Section: Effects Of Liver Cirrhosis On the Intestinal Barriermentioning

confidence: 99%

Intestinal permeability in a patient with liver cirrhosis

Valadez

Rivera-Espinosa

Méndez-Guerrero

et al. 2016

TCRM

View full text Add to dashboard Cite

Liver cirrhosis is a worldwide public health problem, and patients with this disease are at high risk of developing complications, bacterial translocation from the intestinal lumen to the mesenteric nodes, and systemic circulation, resulting in the development of severe complications related to high mortality rate. The intestinal barrier is a structure with a physical and biochemical activity to maintain balance between the external environment, including bacteria and their products, and the internal environment. Patients with liver cirrhosis develop a series of alterations in different components of the intestinal barrier directly associated with the severity of liver disease that finally increased intestinal permeability. A “leaky gut” is an effect produced by damaged intestinal barrier; alterations in the function of tight junction proteins are related to bacterial translocation and their products. Instead, increasing serum proinflammatory cytokines and hemodynamics modification, which results in the appearance of complications of liver cirrhosis such as hepatic encephalopathy, variceal hemorrhage, bacterial spontaneous peritonitis, and hepatorenal syndrome. The intestinal microbiota plays a fundamental role in maintaining the proper function of the intestinal barrier; bacterial overgrowth and dysbiosis are two phenomena often present in people with liver cirrhosis favoring bacterial translocation. Increased intestinal permeability has an important role in the genesis of these complications, and treating it could be the base for prevention and partial treatment of these complications.

show abstract

“…The abnormalities in migrating motor complexes and increased clustered activity are more severe in Child-Pugh stage C cirrhotic patients compared to stage A patients; also, the extent of small bowel dysmotility is related to the degree of liver failure [52, 57, 58] and presence of portal hypertension [56]. Furthermore, these abnormalities in intestinal motility are reversed following liver transplantation [59].…”

Section: 0 Novel Strategiesmentioning

confidence: 99%

“…Indeed, decompensated cirrhotic patients have slower intestinal transit times than patients with compensated cirrhosis [58], with a significant correlation between small bowel transit time and Child-Pugh score (R=0.77, p=0.0003) [58]. These abnormalities in bowel motility and transit times are conducive to bacterial overgrowth, as patients with cirrhosis and a history of SBP have a significantly higher incidence of bacterial overgrowth compared to cirrhotic patients without SBP [52].…”

Section: 0 Novel Strategiesmentioning

confidence: 99%

Novel prevention strategies for bacterial infections in cirrhosis

Yan

García–Tsao

2016

Expert Opinion on Pharmacotherapy

Self Cite

View full text Add to dashboard Cite

Introduction Bacterial infections are a serious complication of cirrhosis, as they can lead to decompensation, multiple organ failure, and/or death. Preventing infections is therefore very relevant. Because gut bacterial translocation is their main pathogenic mechanism, prevention of infections is mostly based on the use of orally administered poorly absorbed antibiotics such as norfloxacin (selective intestinal decontamination). However, antibiotic prophylaxis leads to antibiotic resistance, limiting therapy and increasing morbidity and mortality. Prevention of bacterial infections in cirrhosis should therefore move away from antibiotics. Areas Covered This review focuses on various potentially novel methods to prevent infections in cirrhosis focusing on non-antibiotic strategies. The use of probiotics, nonselective intestinal decontamination with rifaximin, prokinetics and beta-blockers or fecal microbiota transplant as means of targeting altered gut microbiota, bile acids and FXR agonists are all potential alternatives to selective intestinal decontamination. Prokinetics and beta-blockers can improve intestinal motility, while bile acids and FXR agonists help by improving the intestinal barrier. Finally, granulocyte colony stimulating factor (G-CSF) and statins are emerging therapeutic strategies that may improve immune dysfunction in cirrhosis. Expert Opinion Evidence for these strategies has been restricted to animal studies and proof-of concept studies but we expect this to change in coming years.

show abstract

Decompensated Cirrhotics Have Slower Intestinal Transit Times as Compared With Compensated Cirrhotics and Healthy Controls

Cited by 39 publications

References 3 publications

Gastrointestinal Motility Disorders and Their Clinical Implications in Cirrhosis

Gastrointestinal Motility Disorders and Their Clinical Implications in Cirrhosis

Intestinal permeability in a patient with liver cirrhosis

Novel prevention strategies for bacterial infections in cirrhosis

Contact Info

Product

Resources

About