Intestinal permeability and complications in liver cirrhosis: A prospective cohort study

Benjamin, Jaya; Singla, Vikas; Arora, Indu; Sood, Seema; Joshi, Yogendra

doi:10.1111/j.1872-034x.2012.01054.x

Cited by 36 publications

(25 citation statements)

References 43 publications

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“…The percentage excretion of lactulose and mannitol in healthy volunteers in our laboratory was obtained from urine collected over a 6‐hour period. Since most of the recent studies have been tested in 5 hours, 29 , 35 , 43 , 55 ‐ 57 and this time is less stressful for patients who must remain in the hospital until the end of the test, we have reduced the patients' urine collection time to 5 hours. However, this difference between controls and patients does not compromise the results since, according to Travis and Menzies, 32 the percentage of urinary excretion of lactulose and mannitol is minimal and not significant between 5 and 6 hours of collection.…”

Section: Discussionmentioning

confidence: 99%

Nutrition Status and Intestinal Permeability in Patients Eligible for Liver Transplantation

Liboredo¹,

Vilela²,

Ferrari³

et al. 2013

J Parenter Enteral Nutr

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Section: Discussionmentioning

confidence: 99%

Nutrition Status and Intestinal Permeability in Patients Eligible for Liver Transplantation

Liboredo¹,

Vilela²,

Ferrari³

et al. 2013

J Parenter Enteral Nutr

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“…Studies assessing intestinal permeability in patients with cirrhosis are given in Table . Most studies found a significantly increased small intestinal , gastroduodenal and whole intestinal permeability in patients with cirrhosis when compared with healthy subjects, despite different methods used ( e.g . test markers) and patients included ( e.g .…”

Section: The Intestinal Epithelial Barriermentioning

confidence: 99%

Intestinal epithelial barrier function in liver cirrhosis: an extensive review of the literature

Pijls

Jonkers

Elamin

et al. 2013

Liver International

107

104

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Recent evidence suggests that translocation of bacteria and bacterial products, such as endotoxin from the intestinal lumen into the systemic circulation is a contributing factor in the pathogenesis of chronic liver diseases and the development of complications in cirrhosis. In addition to alterations in the intestinal microbiota and immune system, dysfunction of the intestinal epithelial barrier may be an important factor facilitating bacterial translocation. This review aims to provide an overview of the current evidence of intestinal epithelial barrier dysfunction in human chronic liver diseases and cirrhosis, and to discuss possible contributing factors and mechanisms. Data suggest the presence of intestinal epithelial barrier dysfunction in patients with chronic liver diseases, but are more convincing in patients with cirrhosis, especially in those with complications. The barrier dysfunction can result from both direct and indirect effects of aetiological factors, such as alcohol and obesity, which can cause chronic liver diseases and ultimately cirrhosis. On the other hand characteristics of cirrhosis itself, including portal hypertension, alterations in the intestinal microbiota, inflammation and oxidative stress can affect barrier function of both small and large intestine and may contribute to the development of complications. In conclusion, there are indications for intestinal epithelial barrier dysfunction in patients with chronic liver diseases and especially in patients with cirrhosis, which can be caused by various factors affecting both the small and large intestine.

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“…Several studies have found a significantly increased intestinal permeability of small intestinal, gastroduodenal and whole intestine in patients with LC when compared with healthy subjects (36,37). There had been several indications for the presence of intestinal epithelial barrier dysfunction in patients with LC, especially in those with cirrhosis complications (38).…”

Section: Possible Underlying Mechanismsmentioning

confidence: 99%

Effect of liver cirrhosis on metastasis in colorectal cancer patients: a nationwide population-based cohort study

Chiou

Chang

Tseng

et al. 2014

Japanese Journal of Clinical Oncology

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Objective: The aim of this study is to evaluate the liver metastasis risk among colorectal cancer patients with liver cirrhosis. Methods: This was a nationwide population-based cohort study of 2973 newly diagnosed colorectal cancer patients with liver cirrhosis and 11 892 age-sex matched controls enrolled in Taiwan between 2000 and 2010. The cumulative risk by Kaplan-Meier method, hazard ratio by the multivariate Cox proportional model and the incidence density were evaluated. Results: The median time interval from the colorectal cancer diagnosis to the liver metastasis event was 7.42 months for liver cirrhosis group and 7.67 months for non-liver cirrhosis group. The incidence density of liver metastasis was higher in the liver cirrhosis group (61.92/1000 person-years) than in the non-liver cirrhosis group (47.48/1000 person-years), with a significantly adjusted hazard ratio of 1.15 (95% CI = 1.04-1.28, P = 0.007). The 10-year cumulative risk of liver metastasis for the liver cirrhosis and the non-liver cirrhosis group was 27.1 and 23.6%, respectively (P = 0.006). For early cancer stage with locoregional disease patients receiving surgery alone without adjuvant anti-cancer treatments, patients with liver cirrhosis (10-year cumulative risk 23.9 vs. 15.7%, P < 0.001) or cirrhotic symptoms (10-year cumulative risk 25.6 vs. 16.6%, P = 0.009) both still had higher liver metastasis risk compared with their counterparts. For etiologies of liver cirrhosis, the 10-year cumulative risk for hepatitis B virus and hepatitis C virus, hepatitis B virus, hepatitis C virus, other causes and nonliver cirrhosis were 29.5, 28.9, 27.5, 26.7 and 23.4%, respectively, (P = 0.03). Conclusions: Our study found that liver metastasis risk was underestimated and even higher in colorectal cancer patients with liver cirrhosis.

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Intestinal permeability and complications in liver cirrhosis: A prospective cohort study

Abstract: IP was increased in 35% of patients with LC; however, it was not associated with a higher incidence of disease-related complications.

Cited by 36 publications

References 43 publications

Nutrition Status and Intestinal Permeability in Patients Eligible for Liver Transplantation

Nutrition Status and Intestinal Permeability in Patients Eligible for Liver Transplantation

Intestinal epithelial barrier function in liver cirrhosis: an extensive review of the literature

Effect of liver cirrhosis on metastasis in colorectal cancer patients: a nationwide population-based cohort study

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