Increased prevalence of intestinal inflammation in patients with liver cirrhosis

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-L inked immunosorbent assay: albumin ( Alb), transferrin (Tf), and alpha(1)-antitrypsin (alpha(1)-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, alpha(1)-AT, and PMN-elastase were increased in 33 (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 overlooked in cirrhotic patients, since it may contribute to or cause intestinal protein loss and other various pathological conditions.