Bacterial Flora of the Small Intestine and Bile Acid Metabolism in Patients with Hepatico-Jejunostomy Roux-en-Y

Abstract

Duodenal and jejunal bacterial flora and bile acid metabolism were investigated in 14 patients with hepatico-jejunostomy Roux-en-Y. Anaerobic culture procedures were based on the use of a glove-box with an oxygen-free atmosphere and pre-reduced, anaerobically sterilized media. Anaerobic transport was based on evacuation of atmospheric air from transport-tubes and transport-time less than 30 minutes. Bile acid metabolism was evaluated from concentrations of total bile acids and deconjugated bile acids, glycine/taurine ratio and breath test. In 92 per cent of the patients an abnormal flora containing anaerobic and/or aerobic bacteria was found in the most proximal part of the jejunum at the site of the entero-entero anastomosis (cf. Fig. 1 and Table I). Total bile acid concentrations were low in half of the patients, whereas deconjugated bile acids or elevated glycine/taurine ratio was found in one patient only (cf. Table II). An abnormal breath test was found in 5 patients, but without any clear correlation between the breath test and the bacterial flora.

Key-words:

• Bacterial flora
• bile acids
• breath test
• hepatico-jejunostomy
• small intestine