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Bacterial Overgrowth

Bacterial overgrowth should be considered in any patient with diarrhea, steatorrhea, weight loss, or macrocytic anemia, especially if the patient has a predisposing cause (such as prior gastrointestinal surgery). A stool collection should be obtained to corroborate the presence of steatorrhea. Small bowel barium radiography may be helpful to document conditions predisposing to intestinal stasis. Where indicated, a small intestinal biopsy may be necessary to exclude other mucosal malabsorptive conditions. A specific diagnosis can be established firmly only by an aspirate and culture of proximal jejunal secretion that demonstrates over 105 organisms/mL.

The Bacterial Overgrowth is a lower number of bacteria in the small bowel as compared to the large bowel because of the forward peristalsis of the intestinal tract, bacteriocidal action of gastric acid and bile, reduction by enzymatic digestion and mucus entrapment, low exposure from the environment, and presence of an ileocecal valve. The great thing about low-carb eating plans is that they require you to give up processed, nutrient-depleted carbs.

The Bacterial Overgrowth Intestinal bacterial overgrowth occurs when the normal bacterial population of the gut has been eradicated. As I mentioned in last month's article. The breakdown of nutrients by the bacteria in the small intestines can damage the cells lining the intestinal wall. That is person with the condition may not absorb enough nutrients.Bacterial Overgrowth low-carb craze is in full swing and doesn't appear to be going away any time soon.

Treatment of bacterial overgrowth

Where possible, the anatomic defect that has potentiated bacterial overgrowth should be corrected. Otherwise, treatment as follows for 1–2 weeks with broad-spectrum antibiotics effective against enteric aerobes and anaerobes usually leads to dramatic improvement: twice daily ciprofloxacin 500 mg, norfloxacin 400 mg, or amoxicillin clavulanate 875 mg, or a combination of metronidazole 250 mg three times daily plus either trimethoprim-sulfamethoxazole (one double-strength tablet) twice daily or cephalexin 250 mg four times daily.

In patients in whom symptoms recur off antibiotics, cyclic therapy (eg, 1 week out of 4) may be sufficient. Continuous antibiotics should be avoided, if possible, to avoid development of bacterial antibiotic resistance.

In patients with severe intestinal dysmotility, treatment with small doses of octreotide may prove to be of benefit. Some most common treatment of Bacterial Overgrowth:

  • Correct underlying primary cause if there is one.
  • Tetracyclines at a dose rate of 20mg/kg body weight every 8 hours for 10-14 day course - which has to be repeated if the condition recurs.
  • Treatment also involves getting enough fluids and nutrition.
  • If the person is already dehydrated, he or she may need intravenous (IV) fluids in a hospital.
  • If already malnourished, total parenteral nutrition (TPN) may be necessary. TPN is nutrition administered intravenously.
  • Patients with nonidiopathic BOS appear to respond well to tetracycline. Bacterial sensitivities from duodenal intubations in these patients suggest using amoxicillin-clavulanate. Amoxicillin-clavulanate appears to be 75% effective in patients with diabetes.
  • Clindamycin and metronidazole are useful for elderly patients with idiopathic BOS.
  • There are many options available for treating bacterial dysbiosis but it generally boils down to a change in diet and/or taking an anti-bacterial agent along with probiotics/prebiotics.

Causes of bacterial overgrowth include:

(1) gastric achlorhydria (especially if other predisposing conditions are present);

(2) anatomic abnormalities of the small intestine with stagnation (afferent limb of Billroth II gastrojejunostomy, small intestine diverticula, obstruction, blind loop, radiation enteritis);

(3) small intestine motility disorders (scleroderma, diabetic enteropathy, chronic intestinal pseudo-obstruction);

(4) gastrocolic or coloenteric fistula (Crohn's disease, malignancy, surgical resection); and

(5) miscellaneous disorders (AIDS, chronic pancreatitis). Bacterial overgrowth is an important cause of malabsorption in the elderly, perhaps because of decreased gastric acidity or impaired intestinal motility.


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