The assessment of the small intestine parietal microbiota in patients with chronic pancreatitis
AbstractThe frequency of small intestine bacterial overgrowth in chronic pancreatitis exceeds half of all the cases. Therefore, the definition and correction of small intestine microbiota’s changes is necessary action in complex therapy of this disease. The modern method of microorganism’s study is the method of polymerase chain reaction in real-time, which allows not only qualitative, but also quantitative DNA assessment of the investigated material.
Objective: to study the state of the proximal small intestine’s parietal microflora in patients with chronic pancreatitis, and assess the reasonableness of biocorrection in chronic pancreatitis therapy.
Materials and methods: the study included 60 patients aged from 25 to 60 years old with chronic pancreatitis. In all examined held esophagogastroscopy with biopsy of the proximal small intestine mucous membrane to study the material PCR in real time (n=60). Half of the patients in addition to the standard therapy were appointed four-week intestinal biocorrection course. 15 persons received synbiotic Normoflorin-D, as many patients received prebiotic Pectovit. After a month of treatment these 30 patients were re-studied of the small intestine microbiocenosis. In addition, as a control group (GK), in our work we used the data of work Lavrentieva O.A. – 13 healthy volunteers, which explored the proximal small intestine microflora by PCR in real time.
Results: The overall bacterial mass in patients with chronic pancreatitis amounted to 4,04 lg (GE/sample), in the control group this indicator was 3,8 lg (GE/sample). No significant differences in these data is not defined. In patients, who received a synbiotic Normoflorin-D, the total number of the proximal small intestine bacteria parietal microflora was 4,13 lg (GE/sample), 4 weeks after the end of the course of biocorrection – 4,16 lg (GE/sample). In these patients revealed a significant decrease in the level of Corynebacterium spp. (p0,05). In the group of patients receiving Pectovit, before the treatment, the total number of proximal small intestine mucosal bacteria was 4,06 lg (GE/sample), 4 weeks after the end of biocorrection - 3,86 lg (GE/sample). In these patients after therapy significantly increased content of Enterococcus spp. (p0,05).
Conclusions: Thus, we have not confirmed data of SIBO development in the majority of patients with chronic pancreatitis by the PCR in real time method. In patients with CP on the background of prebiotic Pectovit marked decrease in the overall bacterial mass, with the appointment of a symbiotic Normoflorin - D. this figure has increased.
Keywords:small intestine bacterial overgrowth, chronic pancreatitis, polymerase chain reaction in real-time