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[Production, absorption and excretion of phenols in intestinal obstruction]
Abstract:
In intestinal obstruction, phenols were produced in the distended loop proximal to obstruction by enteric bacteria. Clinically, in 17 cases of non-strangulated intestinal obstruction, phenols were detected in 15 cases and mean concentration of phenols was 4.2 +/- 9.7 micro g/ml(mean +/- 1 SD). In the fraction of phenols, p-cresol was detected in 15 cases and mean concentration was 3.8 +/- 7.7 and phenol was detected in 4 cases and mean concentration was 0.5 +/- 2.6. Phenols were decreased as clinical improvement of intestinal obstruction. Enteric bacteria in enteric juice ranged from 10(4) to 10(10)/ml and its change paralleled to phenols concentration. Mean urinary concentration of phenols in intestinal obstruction was increased to 297 +/- 415 mg/day compared to control (less than 50 mg/day). Its change also paralleled to phenols concentration in enteric juice. Closed ileal loop was made in dogs and phenols were infused in the loop. Phenols were increased in the portal vein 5 min after the infusion and in the femoral vein 60 min after the infusion. Phenols, which was thought to be toxic to the host, were proved to be produced in the distended intestine and excreted from the kidney.
Insights
In intestinal obstruction, enteric bacteria produce phenols in the gut. These phenol levels, including p-cresol, correlate with bacterial load and decrease with clinical improvement, indicating their role in the condition.
Area of Science:
- Biochemistry
- Gastroenterology
- Microbiology
Context:
- Intestinal obstruction is a serious condition with potential toxic complications.
- The role of bacterial metabolites in the pathophysiology of intestinal obstruction is not fully understood.
Purpose:
- To investigate the production and significance of phenols in intestinal obstruction.
- To determine the correlation between phenol levels, bacterial presence, and clinical outcomes.
Summary:
- Phenols, including p-cresol, are produced by enteric bacteria in the distended intestinal loops of patients with obstruction.
- Phenol concentrations in enteric juice and urine were significantly elevated in patients with intestinal obstruction compared to controls.
- Bacterial counts in enteric juice paralleled phenol concentrations, and both decreased with clinical improvement.
Impact:
- This study demonstrates that phenols are endogenous toxins produced in the obstructed intestine.
- Findings suggest phenols may contribute to the toxicity associated with intestinal obstruction and are excreted via the kidneys.