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Alterations in intestinal motility and microflora in experimental acute pancreatitis
Conclusion:
A delay in intestinal transit time appears as an early event in acute pancreatitis, preceding intestinal bacterial overgrowth and translocation.
Background:
Septic complications, primarily caused by bacteria of enteric origin, are frequent in severe acute pancreatitis. Impairment in intestinal motility probably plays a pathophysiological role in the development of bacterial overgrowth and ensuing translocation.
Methods:
In the present study, the influence of acute pancreatitis on intestinal motility was evaluated by measuring small intestinal transit time in the rat. Acute pancreatitis was induced by the retrograde intraductal infusion of 0.2 mL taurodeoxycholate. Intestinal transit time was studied by intraduodenal injection of Krebs' phosphate-buffered solution labeled with Na2(51)CrCO4, and 1 h small intestinal transit was measured at 1, 3, 12, and 24 h, after induction of pancreatitis. Bacterial overgrowth was evaluated by measuring Escherichia coli counts in the colon and distal small intestine, and bacterial translocation to mesenteric lymph nodes, the liver, spleen, and pancreas was determined.
Results:
A delayed small intestinal transit time was noted from 3 h on after induction of acute pancreatitis, with most of the radioactivity retained in the first two intestinal segments. Overgrowth of E. coli was noted 12 h after induction of pancreatitis in both the colon and distal small intestine, and at the same time-point, a significant increase in the incidence of bacterial translocation to mesenteric lymph nodes was seen.
Insights
In acute pancreatitis, delayed intestinal transit occurs early, preceding bacterial overgrowth and translocation. This study in rats shows impaired motility is an initial event in severe pancreatitis complications.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Microbiology
Background:
- Severe acute pancreatitis frequently leads to septic complications from enteric bacteria.
- Intestinal motility impairment is implicated in bacterial overgrowth and translocation.
Purpose of the Study:
- To investigate the impact of acute pancreatitis on intestinal motility.
- To determine the temporal relationship between impaired motility, bacterial overgrowth, and translocation.
Main Methods:
- Acute pancreatitis induced via taurodeoxycholate infusion in rats.
- Small intestinal transit time measured using radiolabeled solution (Na2(51)CrCO4).
- Bacterial overgrowth (E. coli) and translocation assessed in various organs.
Main Results:
- Delayed small intestinal transit observed starting 3 hours post-pancreatitis induction.
- E. coli overgrowth detected in the colon and distal small intestine at 12 hours.
- Increased bacterial translocation to mesenteric lymph nodes noted at 12 hours.
Conclusions:
- Delayed intestinal transit is an early event in acute pancreatitis.
- This motility delay precedes bacterial overgrowth and translocation.
- Findings highlight the role of impaired gut motility in pancreatitis-associated sepsis.