Abnormal fecal flora in a patient with short bowel syndrome

Autor: Caldarini, M., Pons, S., D'Agostino, D., Depaula, J., Greco, G., Negri, G., Ascione, A., Bustos, D.
Zdroj: Digestive Diseases and Sciences; August 1996, Vol. 41 Issue: 8 p1649-1652, 4p
Abstrakt: Abstract: d-Lactic acidosis associated with encephalopathy is a clinical condition that occurs in patients with short bowel syndrome. We studied the fecal flora and the composition of fecal water of a child who developed this unusual disorder. Bacteriological studies showed that the patient's stool contained a marked predominance of gram-positive anaerobes. Two strains were identified,Lactobacillus plantarum andLactobacillus salivarius, as the main bacteria isolated. Fecal water showed pH 4.8 and total lactic acid (sum ofl- andd-lactic acids) was the principal organic anion found in the feces. We also incubated the patient's stool in a continuous culture with a view to determining the effect of the pH on the production of volatile fatty acids (VFA) andl- andd-lactic acids. The culture was maintained at pH 5.0, 5.5, 6.0, and 6.5 for four consecutive periods of four days each. We then studied the culture for a further four days at pH 5.0 once again. This study showed that with the progressive rise of the pH from 5.0 to 6.5l- andd-lactic acids decreased and VFA production increased.d-Lactic acid formation was inhibited at pH 6.5, but when the culture was returned to pH 5.0, it increased to a high level again. These results suggest that the pH plays an important role in the ecological changes in the colonic bacteria that result ind-lactic acid production.
Databáze: Supplemental Index