Microbiological and immunological effects of enteral feeding on the upper gastrointestinal tract

Aileen Robertson Smith, Sandra Macfarlane, Elizabeth Furrie, Shakil Ahmed, Bahram Bahrami, Nigel Reynolds, George Tennant Macfarlane

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    Abstract

    Enteral feeding via a percutaneous endoscopic gastrostomy tube is required for nutritional support in patients with dysphagia. Enteral tube feeding bypasses the innate defence mechanisms in the upper gastrointestinal tract. This study examined the surface-associated microbial populations and immune response in the gastric and duodenal mucosae of eight enteral nutrition (EN) patients and ten controls. Real-time PCR and fluorescence in situ hybridization were employed to assess microbiota composition and mucosal pro-inflammatory cytokine expression. The results showed that EN patients had significantly higher levels of bacterial DNA in mucosa, biopsies from the stomach and duodenum (P<0.05) than the controls, and that enterobacteria were the predominant colonizing species on mucosal surfaces in these individuals. Expression of the pro-inflammatory cytokines interleukin (IL)-1 alpha, IL-6 and tumour necrosis factor-a was significantly higher in gastric and small intestinal mucosae from patients fed normal diets in comparison with those receiving EN (P<0.05). These results indicate that EN can lead to significant bacterial overgrowth on upper gastrointestinal tract mucosae and a significantly diminished pro-inflammatory cytokine response.

    Original languageEnglish
    Pages (from-to)359-365
    Number of pages7
    JournalJournal of Medical Microbiology
    Volume60
    Issue number3
    Early online date18 Nov 2010
    DOIs
    Publication statusPublished - Mar 2011

    Keywords

    • In situ hybridization
    • Percutaneous endoscopic gastronomy
    • Targeted oligonucleotide probes
    • Bacterial translocation
    • Helicobacter pylori
    • Ulcerative colitis
    • Gut
    • Populations
    • Flora
    • Bifidobacterium

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