Impaired Accommodation of Proximal Stomach in Patients with Alcoholic Liver Cirrhosis

Izbéki, Ferenc; Kiss, I; Wittmann, Tibor; Várkonyi, Tamás; Légrády, Péter; Lonovics, János

doi:10.1080/003655202762671279

Cited by 31 publications

(19 citation statements)

References 44 publications

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“…In a previous ultrasonographic study, reduced relaxation of the proximal stomach after a meal was reported in patients with alcoholic liver cirrhosis compared to healthy controls [61]. However, ongoing alcohol overconsumption was not mentioned as an exclusion criterion in this study [61].…”

Section: Gastric Sensorimotor Dysfunction (Ii)mentioning

confidence: 73%

“…However, ongoing alcohol overconsumption was not mentioned as an exclusion criterion in this study [61]. Acute and chronic alcohol consumption have been associated with altered motility in the esophagus, stomach, and the small intestine [165,166].…”

Section: Gastric Sensorimotor Dysfunction (Ii)mentioning

confidence: 98%

“…Gastric accommodation has been found to be impaired in patients with alcoholic cirrhosis in an ultrasonographic study [61] and in cirrhotic patients with tense ascites in a study involving SPECT compared to healthy controls [62]. However, gastric accommodation and gastric sensory function have not been investigated with a gastric barostat in liver cirrhosis and data on the effects of altered gastric motility and sensitivity on energy intake and gastrointestinal symptoms are lacking in this group of patients.…”

Section: Gastric Sensorimotor Function 231 Gastric Accommodationmentioning

confidence: 99%

“…Acute and chronic alcohol consumption have been associated with altered motility in the esophagus, stomach, and the small intestine [165,166]. To date, there are no published studies on the effects of alcohol on gastric accommodation, but it is possible that the results of Izbéki et al might be due to alcohol per se, if patients had not been abstinent, and, in any case, they may not be generalized for liver cirrhosis of any cause [61]. In the current study, only 7/16 patients had alcoholic liver cirrhosis and they had been abstinent for at least 6 months before inclusion.…”

Section: Gastric Sensorimotor Dysfunction (Ii)mentioning

confidence: 99%

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Intestinal permeability in cirrhotic patients with and without ascites

Kalaitzakis

Johansson

Bjarnason³

et al. 2006

Scandinavian Journal of Gastroenterology

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Malnutrition is a common finding in patients with liver cirrhosis. Malnutrition has been shown to be associated with increased morbidity and mortality. Its pathogenesis remains unclear but both poor dietary intake and increased energy expenditure have been reported.Spontaneous bacterial peritonitis is an important clinical problem in cirrhotics. It may occur as a consequence of repeated access of bacteria from the intestinal lumen (translocation) to the mesenteric lymph nodes. One of the mechanisms proposed to explain bacterial translocation in cirrhosis includes increased intestinal permeability.The aims of the present study were to evaluate GI symptoms in cirrhotic patients and their possible relation to nutritional status, to assess whether gastric sensorimotor dysfunction or metabolic disturbances are associated with reduced food intake, and to investigate the role of ascites in intestinal permeability in patients with liver cirrhosis.Gastrointestinal symptoms and health-related quality of life (HRQOL) were assessed with the aid of two questionnaires. Gastric sensorimotor function was measured by means of an electronic barostat. Food intake, as assessed with a food diary, was related to fasting and postprandial glucose, insulin, leptin, and ghrelin concentrations. Intestinal permeability was evaluated by a 51 Cr-EDTA permeability test. Cirrhotics were found to have increased severity of GI symptoms compared with reference values from the general population. A relationship between GI symptoms and compromised HRQOL as well as weight loss was observed.Proximal stomach relaxation to a meal was increased in patients with liver cirrhosis as compared with healthy controls but the relation between gastric accommodation and energy intake was found to be disturbed in these patients. Gastric sensitivity to distension was shown to be related to GI symptom severity and to liver cirrhosis severity scores.Patients with liver cirrhosis exhibited higher postprandial insulin and glucose concentrations compared to controls. Cirrhotics had higher fasting leptin that fell significantly postmeal and they showed an attenuated increase of ghrelin before the next expected meal. Altered glucose and hormonal levels in patients with cirrhosis were associated with poor food intake.Only a few patients with cirrhosis had increased intestinal permeability, as assessed by a 51 Cr-EDTA test, which was not influenced to a major extent by ascites. Conclusions: In patients with liver cirrhosis GI symptom severity is high and it is associated with impaired HRQOL and weight loss. Gastric accommodation is not involved in the poor food intake observed in cirrhotics and gastric sensitivity seems to be a relevant factor for GI symptom generation in these patients. Altered postprandial glucose, leptin, and ghrelin levels are correlated to reduced energy intake in this patient group. Increased intestinal permeability is probably of limited importance in the pathophysiology of bacterial infections in patients with liver cirrhosis and ascites.

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Section: Gastric Sensorimotor Dysfunction (Ii)mentioning

confidence: 73%

Section: Gastric Sensorimotor Dysfunction (Ii)mentioning

confidence: 98%

Section: Gastric Sensorimotor Function 231 Gastric Accommodationmentioning

confidence: 99%

Section: Gastric Sensorimotor Dysfunction (Ii)mentioning

confidence: 99%

See 2 more Smart Citations

Intestinal permeability in cirrhotic patients with and without ascites

Kalaitzakis

Johansson

Bjarnason³

et al. 2006

Scandinavian Journal of Gastroenterology

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show abstract

“…Anorexia, nausea, encephalopathy, gastropathy, ascites, and concurrent alcohol consumption can all contribute to a reduction in dietary intake (6). Malabsorption and maldigestion of nutrients can also result from bile salts deficiency, altered intestinal motility, bacterial overgrowth, mucosal injury, portal hypertensive changes to the intestine, and increased intestinal permeability (7)(8)(9). Apart from the abovementioned established factors, myths and fads about diet related to liver diseases in countries like Pakistan further contributes to the problem.…”

Section: Introductionmentioning

confidence: 99%