Bacterial Overgrowth Syndrome

Bacterial Overgrowth Syndrome

Bacterial Overgrowth Syndrome (BOS) is a condition when the usual bacteria inhabiting the stomach and small intestine increased in number or are overtaken by other infectious agents to produce significant clinical concerns. [1]

Causes

Normally, bacterial count is about < 105 bacteria/mL in the proximal bowel. This is maintained by physiological mechanisms of the body such as normal peristalsis, adequate gastric acid secretion,secretory IgA and integral gastrointestinal structures. Bacterial overgrowth commonly takes place when there are certain structural changes leading to stasis of the contents within the gastrointestinal tract. To name a few, these are strictures, small-bowel diverticulosis, surgical blind loops and obstructions. The disease may also be brought about by motility disorders linked to certain conditions like diabeticneuropathy and amyloidosis. Achlorydia and changes that occur with aging are other causes. [2]

Pathophysiology

When nutrients are consumed by excess bacteria, nutrient deficiency may ensue. Micelle formation is also disrupted as a result of deconjugation of bile salts by the bacteria. This will result to fat malabsorption which then results to diarrhoea. [1]

Signs and Symptoms

BOS manifests with non-specific symptoms. These may include bloating, flatulence, abdominal pain, diarrhoea and weight loss. Serious cases may show malabsorption findings such as anaemia, steatorrhea, night blindness and dermatitis. [1] BOS can also cause fatigue and is being linked to certain diseases such as chronic fatigue syndrome fibromyalgia, and allergies. [3]

Diagnosis

After a series of careful physical examination, a culture of intestinal aspirate showing bacterial count of greater than 105/mL usually with endoscopy is a standard for diagnosing BOS. [2] However, its use was limited because of low specificity. Diagnostic exams should include workup for diarrhoea, anaemia and malabsorption. [1] Breath tests that employ substrates like glucose and xylose are also routinely utilized. To identify anatomic lesions, upper GI series with small-bowel follow-through is also performed.[2]

Treatment 

Treatment of BOS includes managing the primary underlying disease along with antibiotics andproper nutrition. Resistance should be watched out for. When there are anatomic abnormalities, surgical correction is necessary.[1] There are a number of natural cures for BOS including herbal treatment and diet changes. A low- carbohydrate diet can reduce the number of bacteria. Herbs like peppermint oil and probiotic treatment may also help. [3]

References:

 1. http://emedicine.medscape.com/article/212861-overview

 2.http://www.merckmanuals.com/professional/gastrointestinal_disorders/malabsorption_syndromes/bacterial_overgrowth_syndrome.html

 3. http://www.healthguidance.org/entry/9328/1/Treating-Bacterial-Overgrowth-the-Natural-Way.html

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