The small bowel flora in individuals with cecoileal reflux
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Data
2008-09-01
Autores
Machado, Wellington Monteiro [UNESP]
Miranda, José Ricardo Arruda [UNESP]
Morceli, José [UNESP]
Padovani, Carlos Roberto [UNESP]
Título da Revista
ISSN da Revista
Título de Volume
Editor
Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia (IBEPEGE)
Colégio Brasileiro de Cirurgia Digestiva (CBCD)
Sociedade Brasileira de Motilidade Digestiva (SBMD)
Federação Brasileira de Gastroenterologia (FBG)
Sociedade Brasileira de Hepatologia (SBH)
Sociedade Brasileira de Endoscopia Digestiva (SOBED)
Colégio Brasileiro de Cirurgia Digestiva (CBCD)
Sociedade Brasileira de Motilidade Digestiva (SBMD)
Federação Brasileira de Gastroenterologia (FBG)
Sociedade Brasileira de Hepatologia (SBH)
Sociedade Brasileira de Endoscopia Digestiva (SOBED)
Resumo
RACIONAL: Fato de observação não rara, é o encontro de refluxo cecoileal durante realização de enema opaco. As causas e conseqüências deste achado têm sido pouco estudadas. OBJETIVOS: Sabendo que a junção ileocecal exerce função de barreira e proteção contra a invasão do delgado pela flora colônica, realizou-se o presente estudo com a finalidade de investigar se existe contaminação ileal em indivíduos com refluxo cecoileal ao enema opaco. MÉTODOS: Investigaram-se 36 indivíduos, 30 mulheres e 6 homens, idade média de 54 anos, 25 com e 11 com ausência refluxo cecoileal. Todos submetidos a pesquisa de contaminação bacteriana do delgado por intermédio de teste respiratório com lactulose-H2 e a determinação do tempo de trânsito orocecal por meio de biossusceptometria de corrente alternada. A caracterização da contaminação do delgado foi baseada no encurtamento do tempo de trânsito orocecal medido pelo teste da lactulose-H2. RESULTADOS: A comparação dos valores basais do H2, do tempo de trânsito orocecal-H2 e tempo de trânsito orocecal-biossusceptometria de corrente alternada não diferiram estatisticamente entre os grupos com e sem refluxo cecoileal. Quando comparados os tempo de trânsito orocecal-H2 e tempo de trânsito orocecal-biossusceptometria, foi observado aumento de tendência de redução do primeiro em relação ao último nos grupos com refluxo cecoileal e correlação significante entre os dois métodos apenas no grupo-controle, inexistindo nos com refluxo cecoileal. CONCLUSÃO: Encurtamento do tempo de trânsito orocecal-H2 e sua perda de correlação com o tempo de trânsito orocecal-biossusceptometria observado em indivíduos com refluxo cecoileal, sugerem comportamento diferenciado deste grupo em relação ao grupo-controle. Possível explicação para as diferenças registradas entre os grupos, seria a presença de flora anômala nos indivíduos com refluxo cecoileal.
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-H2 and measurement of the orocecal transit time by means of alternate current biosusceptometry. Small intestine bacterial overgrowth was characterized by orocecal transit time-H2 shortening. RESULTS: Comparison of basal H2, orocecal transit time-H2 and orocecal transit time-alternate current biosusceptometry measurements did not statistically differ between the groups with and without cecoileal reflux. Orocecal transit time-H2 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-H2 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.
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-H2 and measurement of the orocecal transit time by means of alternate current biosusceptometry. Small intestine bacterial overgrowth was characterized by orocecal transit time-H2 shortening. RESULTS: Comparison of basal H2, orocecal transit time-H2 and orocecal transit time-alternate current biosusceptometry measurements did not statistically differ between the groups with and without cecoileal reflux. Orocecal transit time-H2 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-H2 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.
Descrição
Palavras-chave
Refluxo cecoileal, Válvula ileocecal, Contaminação do delgado, Supercrescimento bacteriano do delgado, Junção ileocecal, Cecoileal reflux, Ileocecal valve, Small bowel contamination, Small bowel bacterial overgrowth, Ileocecal junction
Como citar
Arquivos de Gastroenterologia. Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, v. 45, n. 3, p. 212-218, 2008.