STATE OF THE COLONIC MICROFLORA IN CHRONIC PANCREATITIS ASSOCIATED WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE
DOI:
https://doi.org/10.11603/1811-2471.2026.v.i1.16130Keywords:
chronic pancreatitis, chronic obstructive pulmonary disease, intestinal microbiocenosis, oxidative stress, endogenous intoxicationAbstract
SUMMARY. The increasing prevalence of comorbid conditions is a characteristic feature of modern internal medicine. The combination of chronic pancreatitis (CP) and chronic obstructive pulmonary disease (COPD) remains insufficiently studied despite its clinical severity. Common pathogenetic mechanisms, including systemic inflammation and oxidative stress, may contribute to significant disturbances of the intestinal microbiocenosis, promoting endogenous intoxication and trophological insufficiency.
The aim – to investigate and compare the quantitative and qualitative composition of the colonic microflora in patients with CP with and without concomitant COPD, as well as to determine correlations between the etiology of dysbiotic disorders and indicators of endogenous intoxication, lipid peroxidation intensity, and the state of the antioxidant defense system.
Material and Methods. 62 patients were examined and divided into two groups: patients with isolated CP and those with comorbid CP and COPD. Diagnoses were verified according to the HaPanEU (2017) and GOLD (2024) guidelines. The state of the intestinal microflora was assessed using bacteriological methods. Statistical analysis was performed using non-parametric methods.
Results. Dysbiotic disorders were detected in 87.8 % of patients with combined CP and COPD, which was significantly higher than in patients with isolated CP (65.0 %). Comorbid patients demonstrated a marked decrease in Bifidobacterium and Lactobacillus levels, along with an increase in Staphylococcus aureus titers and enzymatically altered Escherichia coli strains. The most pronounced microbiocenosis imbalance was observed in patients with CP combined with stage II COPD and was characterized by excessive colonization with opportunistic microorganisms. Correlation analysis revealed significant associations between obligate microflora deficiency and elevated levels of malondialdehyde and middle-molecular substances.
Conclusions. Bacteriological examination of the intestinal microflora in chronic pancreatitis revealed a significant decrease in saccharolytic flora, a significant increase in E. coli due to the predominance of strains with altered enzymatic properties, as well as other opportunistic and pathogenic microorganisms (p < 0.05).
The presence of COPD as a comorbid condition led to an aggravation of pathological changes in the intestinal microflora of patients with chronic pancreatitis: a higher prevalence of intestinal dysbiosis of varying severity was observed in patients with CP + COPD compared to those without COPD (87.8 % vs. 65.0 %), along with a reduced proportion of patients with a normal intestinal microflora state (22.2 % vs. 35.0 %).
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Accepted 2026-04-08
Published 2026-04-22
