Original Articles
Copyright ©The Author(s) 1999. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 15, 1999; 5(5): 391-396
Published online Oct 15, 1999. doi: 10.3748/wjg.v5.i5.391
Increased prevalence of intestinal inflammation in patients with liver cirrhosis
Osamu Saitoh, Kazunori Sugi, Keishi Kojima, Hisashi Matsumoto, Ken Nakagawa, Masanobu Kayazawa, Seigou Tanaka, Tsutomu Teranishi, Ichiro Hirata, Ken-ichi Katsu
Osamu Saitoh, Kazunori Sugi, Keishi Kojima, Ken Nakagawa, Masanobu Kayazawa, Seigou Tanaka, Tsutomu Teranishi, Ichiro Hirata, Ken-ichi Katsu, Second Department of Internal Medicine, Osaka Medical College, Takatsuki, Japan
Hisashi Matsumoto, Department of Gastroenterology, Ijinkai Takeda General Hospital, Kyoto, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Osamu Saitoh, Second Department of internal Medicine, Osaka Medical College, 2.7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan
Telephone: (0726)83-1221 Fax: (0726)84-6532
Received: July 14, 1999
Revised: August 20, 1999
Accepted: September 20, 1999
Published online: October 15, 1999

AIM: To investigate the pathophysiology of the digestive tract in patients with liver cirrhosis.

METHODS: In 42 cirrhotic patients and 20 control subjects, the following fecal proteins were measured by enzyme-linked immunosorbent assay: albumin (Alb), transferrin (Tf), and α1-antitrypsin (α1-AT) as a marker for intestinal protein loss, hemoglobin (Hb) for bleeding, PMN-elastase for intestinal inflammation, and secretory IgA for intestinal immunity.

RESULTS: The fecal concentrations of Hb, Alb, Tf, α1-AT, an d PMN-elastase were increased in 13 (31%), 8 (19%), 10 (24%), 6 (14%), and 11 (26%) cases among 42 patients, respectively. Fecal concentration of secretory IgA was decreased in 7 (17%) of 42 patients. However, these fecal concentrations were not related to the severity or etiology of liver cirrhosis. The serum Alb level was significantly decreased in patients with intestinal protein loss compared to that in patients without intestinal protein loss.

CONCLUSION: These findings suggest that: ① besides the well-known pathological conditions, such as bleeding and protein loss, intestinal inflammation and decreased intestinal immunity are found in cirrhotic patients; ② intestinal protein loss contributes to hypoalbuminemia in cirrhotic patients, and ③ intestinal inflammation should not be over looked in cirrhotic patients, since it may contribute to or cause intestinal protein loss and other various path ological conditions.

Keywords: liver cirrhosis, intestinal, inflammation, secretory IgA, fecal proteins