Alterations in small-bowel microflora in acute intestinal obstruction

Changes in Small Bowel Microflora in Acute Nonstrangulating Obstruction

“…Secondly, the results of Sykes et al [21 ] are similar to ours: while they used small amounts of native contents obtained by needle biopsy and only differentiated between aerobes and anaerobes, the bacterial concentrations reported were only 10-102 times higher than those we found for the Coli species alone. Thirdly, even the aspiration of very small quanti ties of native contents requires special efforts like 'milk ing' the gut with the fingers, so that results of Sykes et al [21] may even reflect falsely elevated regional concentra tions. In a comparison study of germs per gut volume, the washout technique might even produce more reliable results.…”

“…The bacterial flora in the obstructed gut has been speculated to originate either from ingested food or from the sparse indigenous flora [2,3,10,21]. We think it more likely that the bacteria develop from the local flora, as our SBO animals hardly consumed any food, despite their free access to it.…”

“…Clinical experience, however, indicates that the mechanisms discussed are active in modulating the reaction to SBO in humans: the extent and speed of SBO in normal individuals, especially in children, are more impressive than in individuals with a preexisting small intestinal germ proliferation, e.g. patients with Crohn's disease [20] or with a slowly progressing tumor obstruction.…”

“…We used the method of Bishop and Allcock [2] and Hicks et al [ 10] to obtain washout specimens from a gut segment. This method was criticized by Sykes et al [21 ] who postulated an uncontrollable dilution effect and propagated the aspiration of small quantities (0.1 ml) of native con tents.…”

Bacterial Flora in Acute Small Bowel Obstruction

“…Most experimental studies have been car ried out in dogs and rats by producing intes tinal obstruction [2][3][4][5]. Very few investiga tions have been done on the bacterial flora in intestinal obstruction in man during life [1,6]. Acute small bowel obstruction is a fairly common condition in India and car ries a high mortality rate.…”