[ Summary ] |
The gut mucosa is protected by a physical and immunological barrier which guards against intraluminal pathogens and toxins. Severe surgical stress reduces the integrity of this barrier system, leading to bacterial translocation, a phenomenon considered to be an important mechanism underlying systemic inflammatory response and infection subsequent to surgical insults. On the other hand, gut barrier disruption and loss of immune tolerance may cause excessive and chronic inflammatory responses in the gut tissue which may cause inflammatory bowel disease and/or GI tract cancer. Parenteral nutrition without enteral delivery of nutrients may suppress excessive immune responses in the gut, therefore it may be a treatment option for inflammatory bowel disease. However, we need to recognize that lack of enteral nutrition simultaneously impairs the gut barrier and allows various pathogens and antigens to invade the gut. |