ABOUT POSSIBLE MECHANISMS OF INTESTINAL BACTERIAL OVERGROWTH IN CHOLELITHIASIS

Abstract

The aim. To study the frequency and possible causes of the bacterial overgrowth syndrome in patients with cholelithiasis. Materials and methods. The study involved 76 patients with cholelithiasis. Used the results of endoscopic and radiologic studies in addition to general clinical data. The bacterial overgrowth syndrome determined using the hydrogen breath test with lactulose on LaktofaN2 coater AMA (St. Petersburg). Colonic microflora was assessed by seeding feces on different selective media. Results. In 86,8% of patients with cholelithiasis identified the bacterial overgrowth syndrome, accompanied by numerous clinical manifestations, such as bloating, diarrhea, pain and discomfort in the right iliac region, general weakness and fatigue, loss of weight. In most cases (73,6% patients) the bacterial overgrowth syndrome arose against the background of failure ileocecal closing apparatus (75% of patients with prestone stage of cholelithiasis and 82,1% of patients with stone stages of cholelithiasis). In 94,7% of patients had colonic dysbiosis, which promotes cecoileal reflux, thus causing the development of the bacterial overgrowth syndrome. Scarce dysbiosis (decrease of Bifidobacteria, Lactic acid bacteria, Escherichia coli) was more pronounced in patients with stage II and III of cholelithiasis, pathogenic dysbiosis (the presence of opportunistic pathogens) — in patients with stage I of cholelithiasis. In 55,3% of cases the bacterial overgrowth syndrome was due to both ileocecal failure and impaired colonic microflora. In 26,4% of patients the bacterial overgrowth was stored function of the ileocecal valve. Conclusion. In most cases development of the bacterial overgrowth syndrome is due to the insufficiency of the ileocecal obturator apparatus and colonic dysbiosis.