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Ischaemia of the small intestine in patients with systemic sclerosis: Raynaud's phenomenon or chronic vasculopathy?
Ischaemia of the small intestine in patients with systemic sclerosis: Raynaud's phenomenon or chronic vasculopathy?
- Source :
-
QJM : monthly journal of the Association of Physicians [QJM] 1994 Aug; Vol. 87 (8), pp. 495-500. - Publication Year :
- 1994
-
Abstract
- We investigated duodenal and gastric mucosal blood flow by endoscopic laser Doppler flowmetry (LDF) in ten patients with systemic sclerosis (SSc) and in ten healthy volunteers. In addition, we tested for the presence of small bowel bacterial overgrowth by jejunal aspiration. Jejunal aspiration and LDF were done consecutively, via a gastroscope, using a flexible catheter and laser Doppler probe. Following these procedures, two duodenal biopsies were obtained for light and electron microscopy. Mean duodenal and gastric blood flow were significantly lower in patients with SSc than in normal subjects (516 flux units vs. 240, 521 vs. 202, both p < 0.001). There was no correlation between age and blood flow in patients or volunteers. Four of the ten patients had evidence of significant bacterial overgrowth on jejunal aspiration (> 10(5) colony-forming units/ml). These findings support the hypothesis that within the small intestine of patients with SSc, factors independent of bacterial overgrowth may be responsible for malabsorption. The observed reduction in small-intestine mucosal blood flow may play an important contributory role. Further studies are required to determine whether this represents reversible or chronic progressive ischaemia, and its effect on nutrient absorption.
- Subjects :
- Adult
Age Factors
Aged
Blood Pressure
Female
Humans
Intestine, Small microbiology
Laser-Doppler Flowmetry
Malabsorption Syndromes etiology
Malabsorption Syndromes physiopathology
Male
Middle Aged
Raynaud Disease physiopathology
Scleroderma, Systemic microbiology
Duodenum blood supply
Gastric Mucosa blood supply
Intestine, Small blood supply
Ischemia physiopathology
Scleroderma, Systemic physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1460-2725
- Volume :
- 87
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- QJM : monthly journal of the Association of Physicians
- Publication Type :
- Academic Journal
- Accession number :
- 7922302