Small Intestinal Mucosal Immunity and Morphometry in Luminal Overgrowth of Indigenous Gut Flora

Riordan, Stephen M.; McIver, Christopher J.; Wakefield, Denis; Duncombe, V. M.; Thomas, M.; Bolin, T. D.

doi:10.1111/j.1572-0241.2001.03533.x

Cited by 75 publications

(38 citation statements)

References 29 publications

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“…If testing is not available, the management advice can be followed provided that significant colonization by Gram-negative bacilli is present in small bowel (see text for testing of bacterial overgrowth). mune response in the small intestine [196]. These findings emphasize corresponding differences in the pathophysiology for the two types of bacterial overgrowth defined by pathogenesis.…”

Section: Intestinal Mucosal Immunitymentioning

confidence: 69%

The Pathogenesis of Gastrointestinal Bacterial Overgrowth

Husebye

2005

Chemotherapy

137

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The normal indigenous intestinal microflora consists of about 10¹⁵ bacteria that under physiological conditions reside mainly in the lower gastrointestinal tract. Bacterial overgrowth implies abnormal bacterial colonization of the upper gut, resulting from failure of specific defense mechanisms restricting colonization under physiological conditions. At present two types of bacterial overgrowth with defined pathogenesis can be distinguished: (1) gastric overgrowth with upper respiratory tract microflora resulting from selective failure of the gastric acid barrier, and (2) gastrointestinal overgrowth with Gram-negative bacilli (enteric bacteria) resulting from failure of intestinal clearance. Helicobacter pylori-induced gastritis of the oxyntic mucosa is the main cause of acquired failure of the gastric acid barrier, which is common among the healthy elderly. Intestinal clearance may fail as the result of impaired intestinal peristalsis or anatomical abnormalities that alter luminal flow. Impaired peristalsis is associated with conditions interfering with intestinal neuromuscular function including myopathic, neuropathic, autoimmune, infectious, inflammatory, metabolic, endocrine, and neoplastic diseases. Anatomical abnormalities are mainly the result of gastrointestinal surgery, intestinal diverticula or fistula. Combined failure of intestinal clearance and the gastric acid barrier results in more severe colonization with Gram-negative bacilli. Gram-negative bacilli are uncommon in the upper gut of otherwise healthy individuals with gastric hypochlorhydria, being acquired (H. pylori) or drug-induced. Significant bacterial overgrowth with Gram-negative bacilli is a rational in the search for an explanation to optimize clinical management. The clinical significance of colonization with upper respiratory tract microflora remains unclear. Translocation of live bacteria, their metabolic products, or antigens from a small bowel colonized by Gram-negative bacilli play a role in the pathogenesis of spontaneous bacterial peritonitis in hepatic disease and in certain types of sepsis, indicating that further studies can point to new patient populations with potential benefit from medical treatment.

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Section: Intestinal Mucosal Immunitymentioning

confidence: 69%

The Pathogenesis of Gastrointestinal Bacterial Overgrowth

Husebye

2005

Chemotherapy

137

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“…42 However, only some cases in that study had an IEL density above what is currently considered the normal range. In the study by Kakar et al, 13 two cases (4.5%) of intraepithelial lymphocytosis were related to bacterial overgrowth ( Figure 6).…”

Section: Infectionsmentioning

confidence: 79%

Duodenal lymphocytosis with no or minimal enteropathy: much ado about nothing?

2015

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“…Furthermore, these bacteria are in competition with the host for the use of cobalamin, with consequent deficit of B 12 vitamin [43] . Histological alterations of intestinal mucosa with an increased chronic inflammatory infiltrate in the lamina propria and villous blunting have also been reported [44] .…”

Section: Alterations Caused By Microbial Agentsmentioning

confidence: 95%

Classification of Malabsorption Syndromes

Montalto¹,

Santoro²,

D’Onofrio³

et al. 2008

Dig Dis

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Malabsorption syndrome is usually defined as the complex of symptoms secondary to maldigestion and/or malabsorption, realizing when the extension of the disease exceeds the ability of intestine compensation. Several conditions have been recognized as being responsible for this syndrome. Up to now, different criteria have been used to order them, but a definitive classification is still not available because of the complexity of the absorption process, the involvement of different organs and structures, and the coexistence of different mechanisms in some diseases causing malabsorption. We propose a new classification of diseases causing malabsorption syndrome according to the responsible etiopathogenetic mechanisms: (a) alteration of digestive processes; (b) alteration of uptake and transport caused by damage or reduction of absorption surface, and (c) miscellaneous. A comment about the mechanisms responsible for malabsorption is given for all the cited diseases.

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Small Intestinal Mucosal Immunity and Morphometry in Luminal Overgrowth of Indigenous Gut Flora

Abstract: SIBO of oropharyngeal- and colonic-type flora are associated with differing disturbances of local duodenal mucosa. Nonetheless, these would not be readily apparent during routine histological assessment. Old age independently influences duodenal IEL counts.

Cited by 75 publications

References 29 publications

The Pathogenesis of Gastrointestinal Bacterial Overgrowth

The Pathogenesis of Gastrointestinal Bacterial Overgrowth

Duodenal lymphocytosis with no or minimal enteropathy: much ado about nothing?

Classification of Malabsorption Syndromes

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