MUCOSAL BACTERIAL-GROWTH IN THE UPPER GASTROINTESTINAL-TRACT IN ALCOHOLICS (HEAVY DRINKERS)

Background/Aims: Mucosal adherent bacterial flora in chronic alcoholic s was studied and compared to a control group referred for upper endos copy, mainly for dyspepsia. Methods: 22 alcoholics, admitted to hospit al for detoxification, were examined using upper gastrointestinal endo scopy. Gastric and duodenal biopsies were taken for tissue pathology, quantitative and qualitative anaerobic and aerobic bacteriological cul ture and for culture of Helicobacter pylori (antral biopsies). 12 nona lcoholics, admitted for upper endoscopy mainly for dyspepsia, were cho sen as a control group. Seven of these had used gastric acid inhibitor s. Results: Gastrointestinal symptoms were common among alcoholics: 20 /22 (90%) had diarrhea, nausea and/or abdominal pain. There were signs of gastritis by endoscopy in 64% of the alcoholics and in 58% of the controls. Tissue pathology, however, showed active chronic antral gast ritis in 27% of the alcoholics and in 42% of the controls. H. pylori w ere isolated in 7/22 of the alcoholics and in 4/12 of the controls, wh ich corresponds to the mean prevalence for these age groups in Sweden. Significantly more bacteria, dominated by gram-positive aerobic cocci , were present in the gastric biopsies of alcoholics than in those of controls (mean of 2.9 x 10(6)/g material versus 4.4 x 10(5), p < 0.05) . There were 2.6 times more bacteria in the duodenal biopsies of alcoh olics than in those of the controls (p > 0.05, NS). Bacterial overgrow th (defined as >2 x 10(3) organisms/g material) was found in the stoma ch in 20/22 (90%) alcoholics and in 6/12 (50%) controls (p < 0.01). Co nclusion: Alcoholics have an increased frequency of bacterial overgrow th in the upper gastrointestinal tract. This may contribute to the com mon gastrointestinal symptoms.