The small bowel flora in individuals with cecoileal reflux

Abstract

-Background -The observation of cecoileal reflux to barium enema is not rare; however, its causes and consequences have not been widely investigated. Considering that ileocecal junction exerts a function as barrier to invasion of bacteria from colon to small bowel, it seems interesting to study the intestinal microflora in subjects carrying cecoileal reflux. Aims -This study aims at evaluating the ileal flora in individuals with cecoileal reflux. Methods -A group of 36 subjects comprising 30 females and 6 males with a mean age of 54 years was assessed. Twenty-five individuals with cecoileal reflux and 11 without cecoileal reflux were submitted to small intestine contamination evaluation through the breath test with lactulose-H 2 and measurement of the orocecal transit time by means of alternate current biosusceptometry. Small intestine bacterial overgrowth was characterized by orocecal transit time-H 2 shortening. Results -Comparison of basal H 2, orocecal transit time-H 2 and orocecal transit time-alternate current biosusceptometry measurements did not statistically differ between the groups with and without cecoileal reflux. Orocecal transit time-H 2 was significantly smaller than orocecal transit time-alternate current biosusceptometry, particularly in individuals with cecoileal reflux. A significant correlation between the two methods was observed only in relation to control, not existing in relation to cecoileal reflux group. Conclusions -Smaller orocecal transit time-H 2 and the loss of correlation with orocecal transit time-alternate current biosusceptometry observed in the individuals with cecoileal reflux suggest a differentiated behavior for such group relative to control, which could be associated with small intestine bacterial overgrowth. HEADINGS -Cecoileal reflux. Ileocecal valve. Small bowel contamination. Small bowel bacterial overgrowth. Ileocecal junction.

Análise da diversidade da microbiota intestinal de ratos submetidos à ressecção da valva ileocecal e criação de esfíncter artificial

“…Not only anatomical loss, but the ileocecal junction dysfunction, can also evolve with changes in the distribution of microbiota. Machado et al, in a retrospective study with barium enema, identified 25% prevalence of reflux from the colon to the ileum, independent of age and gender 29 . What are the consequences of these changes?…”

Clinical and Psychological Characteristics of Patients with Globus

“…Known since antiquity, the physiopathology of this disorder is still unknown but appears to be multifactorial. Recent studies have focused on gastro-oesophageal reflux disease (GERD) [23], abnormalities of the upper oesophageal sphincter [24,25], psychological and psychiatric disorders [2] as major factors contributing to the Globus sensation [26].…”

Human Colon Microbiota and Mucosal Immune System

“…Function disorders of ileocecal valve causes "small intestinal bacterial overgrowth (SIBO)". Colonic microbiota invade small intestine due to reflux which is the consequences of valve dysfunction and causes nausea, bloating sensation, vomiting, diarrhea, malnutrition and weight loss [15,16]. On the other hand, Haustra coli may be another reason for higher concentration of colonic microbiota.…”