THE ROLE OF ORAL-ADMINISTRATION OF OATMEAL FERMENTED BY LACTOBACILLUS-REUTERI R2LC ON BACTERIAL TRANSLOCATION AFTER ACUTE LIVER-FAILURE INDUCED BY SUBTOTAL LIVER RESECTION IN THE RAT

Background: Previous experimental studies showed that a disturbed ecology of the enteric bacterial population might contribute to the occurrence of bacterial translocation from the gut in acute liver failure (ALF). Methods: In the present study the effects of oral administration of exogenous Lactobacillus reuteri R2LC and oat fiber on bacterial overgrowth and translocation and on enterocyte protein contents were investigated in rats with ALF induced by subtotal liver resection. The oatmeal soup base was anaerobically inoculated with L. reuteri R2LC and fermented for 15 h. The animals were then fed with fermented or unfermented oatmeal or saline daily for 6 days before the experimental procedure. Results: The incidence of bacterial translocation to the systemic circulation was nil and 17% in rats subjected to sham operation with saline or 90% hepatectomy with fermented oatmeal, respectively, and 80-90% and 34-50% in rats subjected to hepatectomy with saline or unfermented oatmeal. One rat treated with fermented oatmeal had positive bacterial growth in mesenteric lymph nodes (MLN), which was significantly lower than in hepatectomized rats with saline or unfermented oatmeal (80-100% and 50-67%). No significant difference was demonstrable between hepatectomized animals with oral administration of fermented or unfermented oatmeal as compared with sham-operated rats. The number of anaerobic bacteria, Gram-negative anaerobes, and Lactobacillus decreased significantly, and the number of Escherichia coli increased in the distal small intestine and colon in hepatectomized animals with saline or unfermented oatmeal, as compared with animals subjected to sham operation or hepatectomy with fermented oatmeal. Conclusions: The occurrence of bacterial translocation from the gut in 90% hepatectomy-induced ALF could be prevented by fermented oatmeal, which implies possibilities for biologically balancing the enteric bacterial ecology.