Gastrointestinal dysfunction in liver cirrhosis.

Publisher: Baishideng Publishing Group Country of Publication: United States NLM ID: 100883448 Publication Model: Print Cited Medium: Internet ISSN: 2219-2840 (Electronic) Linking ISSN: 10079327 NLM ISO Abbreviation: World J Gastroenterol Subsets: MEDLINE

Publication: 2014- : Pleasanton, CA : Baishideng Publishing Group
Original Publication: Beijing : WJG Press, c1998-

Gastrointestinal Motility*; Gastrointestinal Diseases/*etiology ; Gastrointestinal Tract/*physiopathology ; Liver Cirrhosis/*complications; Animals ; Bacterial Translocation ; Enteric Nervous System/physiopathology ; Gastrointestinal Diseases/diagnosis ; Gastrointestinal Diseases/metabolism ; Gastrointestinal Diseases/microbiology ; Gastrointestinal Diseases/physiopathology ; Gastrointestinal Tract/innervation ; Gastrointestinal Tract/metabolism ; Gastrointestinal Tract/microbiology ; Gastrointestinal Tract/pathology ; Humans ; Liver Cirrhosis/diagnosis ; Malnutrition/etiology ; Malnutrition/physiopathology ; Nutritional Status ; Permeability ; Prognosis ; Risk Factors

Patients with liver cirrhosis exhibit several features of gut dysfunction which may contribute to the development of cirrhosis complications as well as have an impact on nutritional status and health-related quality of life. Gastrointestinal symptoms are common in cirrhosis and their pathophysiology probably involves factors related to liver disease severity, psychological distress, and gut dysfunction (e.g., increased gastric sensitivity to distension and delayed gut transit). They may lead to reduced food intake and, thus, may contribute to the nutritional status deterioration in cirrhotic patients. Although tense ascites appears to have a negative impact on meal-induced accommodation of the stomach, published data on gastric accommodation in cirrhotics without significant ascites are not unanimous. Gastric emptying and small bowel transit have generally been shown to be prolonged. This may be related to disturbances in postprandial glucose, insulin, and ghrelin levels, which, in turn, appear to be associated to insulin resistance, a common finding in cirrhosis. Furthermore, small bowel manometry disturbances and delayed gut transit may be associated with the development of small bowel bacterial overgrowth. Finally, several studies have reported intestinal barrier dysfunction in patients with cirrhosis (especially those with portal hypertension), which is related to bacterial translocation and permeation of intestinal bacterial products, e.g., endotoxin and bacterial DNA, thus potentially being involved in the pathogenesis of complications of liver cirrhosis.

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Keywords: Gastric accommodation; Gastrointestinal symptoms; Gut motility; Intestinal permeability; Liver cirrhosis; Malnutrition

Date Created: 20141031 Date Completed: 20150810 Latest Revision: 20220318

20231215

PMC4209534

10.3748/wjg.v20.i40.14686

25356031