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Treatments and drugs
By Mayo Clinic staffWhenever possible, doctors treat blind loop syndrome by dealing with the underlying problem — surgically repairing a postoperative blind loop, stricture or fistula, for example. 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 best way to treat bacterial overgrowth is with antibiotic therapy, and 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 because bacteria can return when the antibiotic is discontinued, the therapy may need to be long term. Some people with a blind loop may go for long periods without needing antibiotics, while other may need regular antibiotic therapy.
Doctors may also switch among different drugs to help prevent bacterial resistance. Ironically, because antibiotics wipe out most intestinal bacteria — both normal and abnormal — they can cause some of the very problems they're trying to cure, including diarrhea and an imbalance of bacteria in the digestive tract.
Nutritional support
Addressing nutritional deficiencies is a crucial part of treating blind loop syndrome, particularly in people with severe weight loss. But although malnutrition can be treated, the damage it causes can't always be reversed.
The following measures 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 and iron supplements.
- Lactose-free diet. Damage to the intestine may cause some people to lose the ability to digest milk sugar (lactose). In that case, it's important to avoid most lactose-containing products including milk and cheese, or use lactase preparations that aid in digestion of milk sugar. Some people may tolerate yogurt because the bacteria used in the culturing process naturally breaks down lactose.
- Medium-chain triglycerides. Trigylcerides are a type of fat consisting of a molecule of glycerol to which three hydrocarbon chains are attached. The chains vary in length, and the way your body processes triglycerides depends on the length of the chains. Most dietary fats are long-chain triglycerides. Food sources include many vegetable oils and animal fats, all of which are emulsified and absorbed in the small intestine. On the other hand, medium-chain triglycerides — found in coconut oil — are absorbed without the aid of digestive enzymes, and are more readily 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.
- Turnage RH, et al. Abdominal wall, umbilicus, peritoneum, mesenteries, omentum, and retroperitoneum. In: Townsend CM, et al. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. 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 Oct. 13, 2009.
- Vanderhoof JA, et al. Pathogenesis, clinical manifestations, and diagnosis of bacterial overgrowth. http://www.uptodate.com/home/index.html. Accessed Oct. 13, 2009.
- 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 Oct. 13, 2009.
- Vanderhoof JA, et al. Treatment of bacterial overgrowth. http://www.uptodate.com/home/index.html. Accessed Oct. 13, 2009.
- 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. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2006. 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 Oct. 13, 2009.
- Picco MF (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 21, 2009.
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