Prevention of Small Bowel Contamination by Ileocecal Valve

Small Bowel Bacterial Overgrowth Syndrome

“…Interdigestive migratory motor complexes appear to perform a 'housekeeper role' since these complexes propel luminal contents along the length of the gut [6], Gastric acid production is also an impor tant factor limiting entry of a large oral inoc ulum of viable organisms into the small bowel [5]. For example, decreased gastric acidity may account for the development of small bowel bacterial overgrowth (SBBO) which has been described in the setting of chronic ethanol abuse [7], Similarly, the ileo cecal valve prevents retrograde colonization of the distal small bowel by organisms that are normally present in the lumen of the large intestine [8], Pancreatic proteins and rapid cell turnover may also inhibit coloni zation and proliferation of organisms [9] but the role of bile acids remains uncertain. The bacterial load which is presented to the bowel may also affect bacterial colonization.…”

Long-Term Effects on Nipple Valve afterMassive Small Bowel Resection on Transit Time and Body Weight

“…Numerous clinical and experimental studies have demonstrated the importance of the ileocecal valve [3,4,7,9,10]. Several attempts have been made to construct an ileocecal valve substitute, especially if the ileocecal valve resection is associated with massive small bowel resection [2,15,19], In the present study we evaluated the long-term effect of a surgically constructed nipple valve on transit time and its relationship to weight loss.…”

“…Resection of the ileocecal valve with massive bowel resection has been implicated in magnifying these complications [9,11,13,17], The ability of the remaining small bowel to adapt following massive resection determines morbidity and mortality. The complications of malnutrition and weight loss seen in patients following massive distal small bowel resection have been attributed to extensive colonization of the remaining small bowel with colonic bacteria and to a decrease in transit time [4,5,7,17,18]. Previous studies from our insititution have demonstrated the bacteriolog ical efficacy of a surgically constructed nipple valve fol lowing massive small bowel resection [2,12], In this study the long-term effects of a surgically constructed nipple valve on body weight, transit time and serum electrolytes were evaluated following massive distal small bowel resec tion including the ileocecal valve.…”

Small bowel bacterial overgrowth in patients after total gastrectomy

“…After total gastrectomy, patients often suffer from abdominal symptoms, malabsorption, steatorrhoea and weight loss [18]. Possible factors influencing this post-gastrectomy syndrome are rapid upper intestinal transit [19], the type of operation [20][21][22][23], lack of gastric lipase [24], primary or secondary exocrine pancreatic insufficiency [25][26][27], pancreatico-cibal dyssynchrony [18,19,[28][29][30] and possibly also small bowel bacterial overgrowth (SBBO) [4,9,19,31,32].…”