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Treatments and drugs
By Mayo Clinic staffWhenever possible, doctors treat blind loop syndrome by dealing with the underlying problem — for example, by surgically repairing a postoperative blind loop, stricture or fistula. But the blind loop can't always be reversed. In that case, treatment focuses on correcting nutritional deficiencies and eliminating bacterial overgrowth.
Antibiotic therapy
For most people, the initial way to treat bacterial overgrowth is with antibiotics. Doctors may start this treatment even when test results are inconclusive. A short course of antibiotics often significantly reduces the number of abnormal bacteria. But bacteria can return when the antibiotic is discontinued, so treatment may need to be long term. Some people with a blind loop may go for long periods without needing antibiotics, while others may need them regularly.
Doctors may also switch among different drugs to help prevent bacterial resistance. Antibiotics wipe out most intestinal bacteria, both normal and abnormal. As a result, antibiotics can cause some of the very problems they're trying to cure, including diarrhea. Switching among different drugs can help avoid this problem.
Nutritional support
Correcting nutritional deficiencies is a crucial part of treating blind loop syndrome, particularly in people with severe weight loss. Malnutrition can be treated, but the damage it causes can't always be reversed.
These treatments may improve vitamin deficiencies, reduce intestinal distress and help with weight gain:
- Nutritional supplements. People with blind loop syndrome may need intramuscular injections of vitamin B-12 as well as oral vitamin, calcium and iron supplements.
- Lactose-free diet. Damage to the small intestine may cause you to lose the ability to digest milk sugar (lactose). In that case, it's important to avoid most lactose-containing products, or use lactase preparations that help digest milk sugar. Some people may tolerate yogurt because the bacteria used in the culturing process naturally break down lactose.
- Medium-chain triglycerides. Most dietary fats consist of a long chain of fat molecules (triglycerides). Medium-chain triglycerides, found in coconut oil, are more easily digested by some people with blind loop syndrome. Medium-chain triglycerides are sometimes prescribed as a dietary supplement for people with severe blind loop syndrome resulting in short bowel syndrome.
- Turnage RH, et al. Abdominal wall, umbilicus, peritoneum, mesenteries, omentum, and retroperitoneum. In: Townsend CM Jr, et al. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 18th ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/164856770-3/902155171/1565/469.html#4-u1.0-B978-1-4160-3675-3..50052-6--cesec137_2746. Accessed Dec. 18, 2011.
- Vanderhoof JA, et al. Clinical manifestations and diagnosis of small bacterial intestinal overgrowth. http://www.uptodate.com/home/index.html. Accessed Dec. 21, 2011.
- Bacterial overgrowth syndrome: Malabsorption syndromes. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec02/ch017/ch017b.html. Accessed Dec. 18, 2011.
- Vanderhoof JA, et al. Treatment of small intestinal bacterial overgrowth. http://www.uptodate.com/home/index.html. Accessed Dec. 21, 2011.
- Vanderhoof JA, et al. Etiology and pathogenesis of small intestinal bacterial overgrowth. http://www.uptodate.com/home/index.html. Accessed Dec. 21, 2011.
- Kahn E, et al. Anatomy, histology, embryology, and developmental anomalies of the small and large intestine. In: Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/das/book/body/164856770-5/902188062/1389/733.html#4-u1.0-B1-4160-0245-6..50104-9--cesec7_4663. Accessed Dec. 21, 2011.
- Picco MF (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 15, 2012.
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