BACKGROUND: Small bowel bacterial overgrowth is a common complication of short bowel syndrome, and although it is often controlled with antimicrobial therapy, alternative strategies may occasionally be needed. METHODS: Six patients with bacterial overgrowth are described, who did not respond to antimicrobial therapy and required additional medical or surgical measures to control the overgrowth. RESULTS: Recalcitrant bacterial overgrowth was successfully treated with periodic small bowel irrigation with a balanced hypertonic electrolyte solution, colonic flushes, encouraging frequent stooling, intestinal lengthening procedure, or probiotic therapy with Lactobacillus plantarum 299V and Lactobacillus GG. CONCLUSIONS: Small bowel bacterial overgrowth should be aggressively evaluated in patients with short bowel syndrome who are not progressing in a normal manner. Inadequate or incomplete response to antibiotic therapy is common, and several additional treatment possibilities are available.
BACKGROUND:Small bowel bacterial overgrowth is a common complication of short bowel syndrome, and although it is often controlled with antimicrobial therapy, alternative strategies may occasionally be needed. METHODS: Six patients with bacterial overgrowth are described, who did not respond to antimicrobial therapy and required additional medical or surgical measures to control the overgrowth. RESULTS: Recalcitrant bacterial overgrowth was successfully treated with periodic small bowel irrigation with a balanced hypertonicelectrolyte solution, colonic flushes, encouraging frequent stooling, intestinal lengthening procedure, or probiotic therapy with Lactobacillus plantarum 299V and Lactobacillus GG. CONCLUSIONS:Small bowel bacterial overgrowth should be aggressively evaluated in patients with short bowel syndrome who are not progressing in a normal manner. Inadequate or incomplete response to antibiotic therapy is common, and several additional treatment possibilities are available.
Authors: Jan Bures; Jiri Cyrany; Darina Kohoutova; Miroslav Förstl; Stanislav Rejchrt; Jaroslav Kvetina; Viktor Vorisek; Marcela Kopacova Journal: World J Gastroenterol Date: 2010-06-28 Impact factor: 5.742
Authors: Holly J Engelstad; Lauren Barron; Joseph Moen; Todd N Wylie; Kristine Wylie; Deborah C Rubin; Nicholas Davidson; W Todd Cade; Barbara B Warner; Brad W Warner Journal: J Am Coll Surg Date: 2018-08-02 Impact factor: 6.113
Authors: Thomas R Ziegler; Menghua Luo; Concepción F Estívariz; Daniel A Moore; Shanthi V Sitaraman; Li Hao; Niloofar Bazargan; Jan-Michael Klapproth; Junqiang Tian; John R Galloway; Lorraine M Leader; Dean P Jones; Andrew T Gewirtz Journal: Am J Physiol Regul Integr Comp Physiol Date: 2007-11-14 Impact factor: 3.619