Jejunal flora of patients with megaoesophagus secondary to Chagas disease

Abstract

The jejunal flora of 15 patients with megaoesophagus secondary to Chagas disease was studied and compared with that of 15 control individuals. In addition to the serological reactions for Chagas disease (immunofluorescence and complement fixation reaction), all subjects were submitted to endoscopy and X-ray of the oesophagus, gastric secretory study and investigation of the jejunal flora. The mean bacterial counts (log10) of Chagas disease patients (4.14 +/- 2.15 c.f.u./ml) was significantly higher than those of the control group (2.83 +/- 1.34 c.f.u./ml). Aerobic bacteria were isolated from 14 Chagasic patients (maximum count 10(10) c.f.u./ml) and 7 controls (maximum count 10(5) c.f.u./ml). Anaerobes were isolated from 7 patients (maximum count 10(7) c.f.u./ml) and 1 control (10 c.f.u./ml). Controls and Chagas disease patients differed significantly in the maximum acid output, but there was no statistically significant relation between bacterial counts and maximum output.

Digestive Tract Microbiota in Healthy Volunteers

“…For the stomach, duodenum, jejunum (proximal and distal), and proximal ileum, similar methods were used. [19][20][21][22] Finally, samples from the distal ileum, colon, and rectum were collected using a new method developed by the authors. 28 The oral cavity presented very diverse microbiota due to the different anatomical sites and constant exposure to the external environment.…”

“…46 This method was tested in our midst by Machado et al, 19 who collected samples of the jejunum liquid in patients suffering from Chagasic achalasia. It was also used by Quintanilha et al 20,21 for qualitative evaluation of microbiota alterations in the proximal jejunum of patients with Chagasic megacolon, both before and after surgery.…”

“…A flexible silicone sampling probe was used with a small (3 mm) distal opening and with a lead weight bound in its extremity. [19][20][21][22][23] This probe was introduced by mouth and swallowed until it reached the stomach, being located by radioscopy. The first sample was collected, aspirating 1 mL of mucus with a 20 mL syringe connected to its proximal end.…”

Intestinal Mucosa-Associated Microflora in Ulcerative Colitis Patients Before and After Restorative Proctocolectomy with an Ileoanal Pouch

“…16,17 The bacterial concentration was expressed in units of colony formation per milliliter (UCF/ml), expressed in logarithm base 10 (Log 10 )…”

Chagasic enteropathy

“…In fact, hyperproliferation of aerobic bacteria and the presence of anaerobic bacteria in the small bowel have been documented in patients with Chagasic megaesophagus and/or megacolon, with the number of colonies being as high in some cases as those occurring in patients with the clinical syndrome of bacterial overgrowth in the small bowel 29 30 51 . Since the participation of changes in gastric secretion was excluded, the abnormality was attributed to disorders of local motility 30 . In support of this hypothesis, it was observed that two cases of Chagasic megajejunum with clearly detectable alterations upon manometry and with confirmed bacterial overgrowth in the small bowel developed the typical clinical syndrome of bacterial overgrowth (chronic diarrhea, evidence of malabsorption and improvement with antibacterial treatment) 9 .…”