Increased oro-cecal transit time in grade I or II hepatic encephalopathy.
The pathogenic mechanisms of hepatic encephalopathy remain to be elucidated. It has been suggested that a digestive motor disorder could promote the absorption of toxins produced within the lumen and thus enhance hepatic encephalopathy.


OBJECTIVE
To evaluate oro-cecal transit time in cirrhotic patients with and without hepatic encephalopathy.


METHODS
Hospitalized patients with alcoholic cirrhosis without encephalopathy and with spontaneous grade I and II encephalopathy were included. Severity of hepatic encephalopathy was assessed clinically and the Child-Pugh score was used to describe cirrhosis severity. Nine healthy volunteers constituted a control group. Oro-cecal transit time was measured with the sulfasalazine test.


RESULTS
Twenty-eight patients (mean age 62.5 +/- 8.5 years) were included. Ten had hepatic encephalopathy of unknown cause and 18 were free of hepatic encephalopathy. Oro-cecal transit time was significantly longer in patients with hepatic encephalopathy (641 +/- 350 min) compared to patients without hepatic encephalopathy (298 +/- 96; P<0.05) and to controls (354 +/- 90; P<0.05). Oro-cecal transit time was comparable for each Child-Pugh score and was not different between the two grades of hepatic encephalopathy.


CONCLUSIONS
Oro-cecal transit time is longer in alcoholic cirrhosis patients with hepatic encephalopathy. This digestive motor disorder provides a partial explanation of hepatic encephalopathy of unknown etiology.
Bouin
Mickael
M
Service d'hépato-gastroentérologie, CHU Côte de Nacre, 14033 Caen Cedex. mickael.bouin@umontreal.ca
Vincent
Catherine
C
Bouhier
Karine
K
Debruyne
Danièle
D
Fatome
Armelle
A
Piquet
Marie-Astrid
MA
Verwaerde
Jean-Claude
JC
Dao
Thong
T
D016022:Case-Control Studies; D005260:Female; D005765:Gastrointestinal Agents / Q000097:blood / Q000493:pharmacokinetics; D005772:Gastrointestinal Transit / Q000502:physiology*; D006501:Hepatic Encephalopathy / Q000145:classification / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D012460:Sulfasalazine / Q000097:blood / Q000493:pharmacokinetics
D005765:Gastrointestinal Agents; D012460:Sulfasalazine