Advances in Clinical and Experimental Medicine

Adv Clin Exp Med
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Advances in Clinical and Experimental Medicine

2009, vol. 18, nr 2, March-April, p. 177–182

Publication type: review article

Language: English

Small Bowel Bacterial Overgrowth – Pathogenesis, Symptoms, Diagnosis, and Treatment

Bakteryjny przerost flory jelita cienkiego – patogeneza, objawy, diagnostyka i leczenie

Tomasz Hutyra1,, Barbara Iwańczak1,

1 Second Chair and Department of Pediatrics, Gastroenterology, and Nutrition, Wroclaw Medical University, Poland

Abstract

Overgrowth of intestinal bacterial flora is the excessive growth of bacteria in the small intestine which usually dwell in the large intestine, which leads to maldigestion, malabsorption, steatorrhea, and anemia. Hypochlorhydria, anatomic anomalies, motor disorders, disturbances in communication between various segments of the alimentary tract, and immunodeficiency predispose to the excessive proliferation of flora in the small intestine. There is no standard diagnostic procedure for an unequivocal diagnosis of bacterial overgrowth in the small intestine. Among the diagnostic methods are direct ones, i.e. quantitative and qualitative assessment of the intestinal content, and indirect ones based on bacterial metabolism, i.e. respiratory tests and a test with para−aminobenzoic acid. The treatment is mainly based on antibiotics active against Gram−negative bacteria and supplementation of nutritional deficiencies.

Streszczenie

Przerost flory jelitowej to nadmierne namnażanie w obrębie jelita cienkiego drobnoustrojów bytujących zwykle w jelicie grubym, prowadzący do zaburzeń trawienia i wchłaniania – zwłaszcza biegunki tłuszczowej i niedokrwistości. Rozwojowi zespołu przerostu bakteryjnego sprzyjają: hipochlorhydria, zaburzenia anatomiczne oraz motoryczne przewodu pokarmowego, zaburzenia komunikacji odcinków przewodu pokarmowego, upośledzona odporność. Nie istnieje standaryzowany test diagnostyczny pozwalający jednoznacznie rozpoznać zespół przerostu bakteryjnego flory jelita cienkiego. Do metod diagnostycznych należą metody bezpośrednie, czyli ilościowe i jakościowe badanie bakterii w treści bliższego odcinka jelita cienkiego oraz metody pośrednie opierające się na metabolizmie drobnoustrojów: testy oddechowe oraz test z kwasem paraaminobenzoesowym. Leczenie polega przede wszystkim na stosowaniu antybiotyków aktywnych wobec bakterii Gram−ujemnych oraz uzupełnianiu niedoborów pokarmowych.

Key words

small bowel bacterial overgrowth, pathogenesis, diagnosis, treatment

Słowa kluczowe

jelitowy przerost bakteryjny, patogeneza, diagnostyka, leczenie

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