The correlation between chronic hepatic diseases and small intestinal inflammation

Objective To investigate the correlation between chronic hepatic diseases and small intestinal inflammation. Methods Patients who received capsule endoscopy in The First Affiliated Hospital of Guangdong Pharmaceutical University were divided into groups of liver cirrhosis, non-alcoholic fatty liver disease(NAFLD), chronic hepatitis and non-hepatic disease according to clinic data from August 2011 to August 2015. The severity of small intestinal mucosal inflammation was graded according to Lewis Scoring system and incidence of small intestinal lesions in different groups and Lewis scores were compared.The liver function was also graded with liver noninvasive scoring systems. Then the correlation between liver function damage and small intestinal lesions was investigated. Results A total of 338 cases were enrolled in the study, including 25 cases of liver cirrhosis, 47 cases of NAFLD, 20 cases of chronic hepaitis and 246 cases of non-hepatic disease. There were 22(88.0%), 36(76.6%), 12(60.0%)and 78(31.7%)cases with lesions in small intestine in the four group respectively with significant differences(P<0.001). Rate of small intestinal villi edema was significantly higher in liver cirrhosis group, NAFLD group, chronic hepatitis group than that in non-hepatic disease group(all P<0.017). Small intestinal villi edema was found mainly in the upper and one third of middle parts in small intestine(P=0.033). Lewis scores of liver cirrhosis group(190.80±228.42)and NAFLD group(125.38±191.31) were higher than those of non-hepatic disease group (42.91±97.69, P=0.021, P=0.034). Forns score, FIB-4 score, NAFLD-FS score and Child-Pugh score were positively correlated with Lewis score (correlation coefficient: 0.247, 0.244, 0.223, 0.284 respectively, all P<0.001). Conclusion Chronic hepatic diseases such as liver cirrhosis, NAFLD, chronic hepatitis might be risk factors for small intestinal mucosal inflammation, and the severity of chronic hepatic diseases may be positively correlated with that of small intestinal mucosal lesions. Key words: Liver cirrhosis; Fatty liver; Chronic hepatitis; Small intestinal mucosal lesions