The role of interdigestive small bowel motility in the regulation of gut microflora, bacterial overgrowth, and bacterial translocation in rats.
OBJECTIVE
To clarify the role of the migrating motor complex (MMC) in the regulation of small intestinal microflora and bacterial translocation.


BACKGROUND
The intestinal microflora may serve as a source of infectious microorganisms. Failure of regulatory mechanisms of the intestinal flora could therefore play an important role in the pathogenesis of gut-derived infections.


METHODS
Rats were fitted with small intestinal myoelectrodes. MMCs were measured on a control day and 3 consecutive days during continuous administration of morphine or placebo. Mesenteric lymph nodes, liver, spleen, peripheral blood, duodenum, and ileum samples were cultured quantitatively.


RESULTS
The mean MMC cycle length in placebo-treated animals was 15.1+/-0.5 minutes. MMCs were completely disrupted after morphine treatment. Total bacterial growth in the duodenum was 7.27+/-0.34 10log colony-forming units (CFU)/g with placebo and 8.28+/-0.27 CFU/g with morphine. In placebo-treated animals, the mean MMC cycle length the day before culturing correlated with total bacterial growth in the duodenum. Translocation incidences to the mesenteric lymph nodes, liver, spleen, and blood were 0/8, 1/8, 0/8, and 0/8 with placebo and 7/8, 6/8, 5/8, and 0/8 with morphine. The overall translocation incidence was 1/8 in placebo-treated animals and 8/8 in morphine-treated animals.


CONCLUSIONS
The MMC is an important mechanism controlling bacterial growth in the upper small bowel. Its disruption with morphine promotes duodenal bacterial overgrowth and bacterial translocation.
Department of Surgery, University Hospital Utrecht, The Netherlands.
V B
VB
Nieuwenhuijs
A
A
Verheem
H
H
van Duijvenbode-Beumer
M R
MR
Visser
J
J
Verhoef
H G
HG
Gooszen
L M
LM
Akkermans
D000818:Animals; D018988:Bacterial Translocation / Q000187:drug effects; D007421:Intestine, Small / Q000187:drug effects / Q000382:microbiology* / Q000503:physiopathology*; D008297:Male; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects; D016065:Myoelectric Complex, Migrating / Q000187:drug effects; D051381:Rats; D017207:Rats, Sprague-Dawley; D013997:Time Factors
D009020:Morphine