The Impact of Residual Bowel After Extended Bowel Resection on Bacterial Overgrowth and Bacterial Translocation

The intestinal mucosa is a major barrier in preventing bacteria invading the body but under certain circumstances mucosal gut barrier can be breached leading to the migration of bacteria to distant organs (mesenteric lymph nodes, spleen and liver). This process is termed bacterial translocation. The abnormal changes in gut ecosystem due to bowel resection led to bacterial overgrowth demonstrated postoperatively in male wistar rats duodenal and stool culture. We proved that after an extended bowel resection there is a direct relation between the number of the intestinal bacteria, the abnormal mucosal structural and functional changes and bacterial translocation to distant organs. A total of 22 male wistar rats divided in 4 groups were studied, short bowel syndrome was simulated in 16 by extended bowel resection (60%, 70% and 75%) while 6 rats had no surgery. Bacterial toxins induced local inflammation which altered neuromuscular tissue function, deteriorated further the gut barrier and increased bacterial overgrowth and bacterial translocation demonstrated by rat's intestinal biopsy results. The sequence of events leading to translocation remained unclear. The correlation between the percentage of the duodenal aspirate Enterococcus and cecal stool bacteria in rats was R= 0.81, while the correlation between duodenal aspirate Enterococcus and cecal stool bacteria of rats without ileocecal valve resection compared to rats with ileocecal valve resection was R= 0.57 being statistically relevant. Simulated short bowel syndrome by extended intestinal resection caused bacteria overgrowth in residual rat's bowel and this subsequently led to bacteria translocation to distant organs.