Gorbach S L, Neale G, Levitan R, Hepner G W
Gut. 1970 Jan;11(1):1-6. doi: 10.1136/gut.11.1.1.
Large quantities of fluid administered through an intestinal tube caused alterations in small bowel bacteriology in four of seven subjects. In two normal individuals, colonic bacteria were found after fluid infusion in areas of the small bowel which previously had none. The faecal microflora was also altered by the fluid purge: anaerobes were reduced in some subjects and large numbers of Enterobacter species emerged in others. In a patient with pancreatic insufficiency and diarrhoea, the concentration of Enterobacter in the faeces was directly related to the number of bowel motions per day. Treatment with pancreatic enzymes curtailed the diarrhoea and markedly reduced these organisms. Intubation showed that Enterobacter were harboured in the small intestine and suppressed in the large bowel during periods of normal bowel action. Diarrhoea caused by pancreatic enzyme withdrawal or fluid purgation removed the colonic inhibition and allowed these organisms to appear in the faeces. Acidic diarrhoea induced by lactose feeding to three hypolactasic patients caused reductions in the numbers of E. coli in the stool but increases in Enterobacter species. Bacteroides also declined in one subject. Certain alterations in small and large bowel bacteriology observed in these forms of experimental diarrhoea have also been described in naturally occurring diarrhoea of diverse aetiologies.
通过肠管给予大量液体导致7名受试者中的4人小肠细菌学发生改变。在两名正常个体中，液体输注后在先前没有结肠细菌的小肠区域发现了结肠细菌。液体灌肠也改变了粪便微生物群：一些受试者的厌氧菌减少，而另一些受试者则出现大量肠杆菌属细菌。在一名患有胰腺功能不全和腹泻的患者中，粪便中肠杆菌的浓度与每天的排便次数直接相关。用胰酶治疗可减少腹泻并显著减少这些细菌。插管显示，在正常排便期间，肠杆菌寄居于小肠并在大肠中受到抑制。由停用胰酶或液体灌肠引起的腹泻消除了结肠的抑制作用，使这些细菌出现在粪便中。给三名乳糖酶缺乏的患者喂食乳糖引起的酸性腹泻导致粪便中大肠杆菌数量减少，但肠杆菌属细菌数量增加。一名受试者中的拟杆菌也减少了。在这些形式的实验性腹泻中观察到的小肠和大肠细菌学的某些改变也在各种病因的自然发生的腹泻中有所描述。
