INFLUENCE OF SMALL INTESTINAL BACTERIAL OVERGROWTH ON THE COMPLICATIONS OF PORTAL HYPERTENSION IN ITS VARIOUS FORMS

Stepanov Yu. M., Chaliy N. V.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Much research has been done on the role of small intestnal bacterial overgrowth (SIBO) in the occurrence and progression of liver diseases. However, the role of SIBO in the course of portal hypertension (PH) in patents with extrahepatc form remains unknown. Purpose of the study. To study the influence of SIBO on the development of complicatons of PH in its various forms. Object and methods. The study included 100 patents with diffuse liver diseases and liver vein pathology, which were divided into groups: I – 65 patents with hepatc PH, II – 20 patents with extrahepatc PH, III – 15 patents without PH. We performed hydrogen breath test with lactulose, esophagogastroduodenoscopy, and a number connectng test. Results. The frequency of detecton of SIBO in patents with hepatc PH was 78.5%, which was 1.7 tmes higher than in its extrahepatc form (45.0%) (χ2=8.2, p=0.005). The development of SIBO in PH was associated with a more frequent development of ascites (OR=5.0) and the third degree of varicose veins of the esophagus (OR=13.9). The detecton of portal gastropathy and the severity of hepatc encephalopathy in patents regardless of the form of PH were practcally independent of the presence of SIBO. The conclusion. In 70.6% of patents with PH there were violatons in the microbiocenosis of the small intestne in the form of SIBO, which prevail in patents with hepatc form of PH. The revealed correlaton between SIBO and the degree of varicose veins of the esophagus as in the group with hepatc PH (r=0.57, p <0.05), and in the group with extrahepatc form (r=0.54, p<0.05) justfes the expediency of correctng small intestnal bacterial overgrowth with the goal of preventng complicatons of PH.

small intestinal bacterial overgrowth, hepatic portal hypertension, extrahepatic portal hypertension

• Giannelli V, Di Gregorio V, Iebba V, Michela G, Schippa S, Merli M, et al. Microbiota and the gut-liver axis: bacterial translocaton, inflammaton and infecton in cirrhosis. World J Gastroenterol. 2014;20(45):16795-810. DOI: 10.3748/wjg.v20.i45.16795
• Lee YY, Tee HP, Mahadeva S. Role of prophylactc antbiotcs in cirrhotc patents with variceal bleeding. World journal of gastroenterology: WJG. 2014;20(7):1790-6. DOI: 10.3748/wjg.v20.i7.1790
• Anikina EV, Kovtun AV, Yakovenko AV, Gioiva IS, Yakovenko EP, Agafonova NA, i dr. Narusheniya kishechnogo biotsenoza v patogeneze tsiroza pecheni i oslozhneniy portalnoy gipertenzii. Experimentalnaya i klinicheskaya gastroenterologiya. 2014;112(12):20-3. [in Russiаn].
• Nemtsov LM. Syndrom izbitochnogo bakterialnogo rosta v kishechnike pri zabolevaniyah pecheni. Zdravoohraneniye. 2015;4:26-34. [in Russiаn].
• Ma YY, Li L, Yu CH, Shen Z, Chen LH, Li YM. Effects of probiotcs on nonalcoholic faty liver disease: a meta-analysis. World J Gastroenterol. 2013 Oct 28;19(40):6911-8. DOI: 10.3748/wjg.v19.i40.6911
• Zharkova MS, Maevskaya MV, Ivashkin VT. Vliyanie syndroma izbitochnogo bakterialnogo rosta i bakterialnoy translokatsii na techenie zabolevaniya u bolnih tsirozom pecheni. Rossiyskiy jurnal gastroenterologii, gepatologii i koloproktologii. 2012;5:56-63. [in Russiаn].
• Maslennikov RV, Driga AA, Ivashkin KV, Jarkova MS, Maevskaya MV, Pavlov ChS, i dr. Rol syndroma izbitochnogo bakterialnogo rosta i systemnogo vospaleniya v patogeneze gemodinamicheskih izmeneniy u bolnih tsirozom pecheni. Rossiyskiy jurnal gastroenterologii, gepatologii i koloproktologii. 2017;3:45-56. [in Russiаn].
• Bernardi M, Moreau R, Angeli P, Schnabl B, Arroyo V. Mechanisms of decompensaton and organ failure in cirrhosis: From peripheral arterial vasodilaton to systemic inflammaton hypothesis. J Hepatol. 2015 Nov;63(5):1272-84. DOI: 10.1016/j.jhep.2015.07.004
• Karman AD, Kazuschik VL. Portalnaya gipertenziya: uchebno-metodicheskoe posobie. Minsk: BGMU; 2014. 40 s. [in Russiаn].
• Luchkevich VS. Osnovi medicinskoy statstki: uchebno-metodicheskoe posobie. Sankt-Peterburg: SZGMU im. I.I. Mechnikova; 2014. 32 s. [in Russiаn]

«Bulletin of problems biology and medicine» Issue 1 Part 2 (143), 2018 year, 195-198 pages, index UDK 616.831.008.87+616.12-008.331.1(075.8)

10.29254/2077-4214-2018-1-2-143-195-198