Disease: Blind loop syndrome


    Blind loop syndrome occurs when part of the small intestine forms a loop that food bypasses during digestion. The presence of this "blind loop" means food may not move normally through the digestive tract.

    Slowly moving food and waste products become a breeding ground for bacteria. The result — bacterial overgrowth — often causes diarrhea and may cause weight loss and malnutrition.

    Sometimes called stasis syndrome or stagnant loop syndrome, blind loop syndrome is often a complication of stomach (abdominal) surgery. But blind loop syndrome can also result from structural problems and some diseases. Sometimes surgery is needed to correct the problem, but antibiotics are the most common treatment.

    Source: http://www.mayoclinic.com


    Signs and symptoms of blind loop syndrome often include:

    • Loss of appetite
    • Abdominal pain
    • Nausea
    • Bloating
    • An uncomfortable feeling of fullness after eating
    • Diarrhea
    • Unintentional weight loss

    When to see a doctor

    Bloating, nausea and diarrhea are signs and symptoms of many intestinal problems. See your doctor for a full evaluation — especially if you've had abdominal surgery — if you have:

    • Persistent diarrhea
    • Rapid, unintentional weight loss
    • Abdominal pain lasting more than a few days

    If you have severe abdominal pain, get immediate medical care.

    Source: http://www.mayoclinic.com


    The small intestine is the longest section of your digestive tract, measuring about 20 feet (6.1 meters). The small intestine is where food mixes with digestive juices and nutrients are absorbed into your bloodstream.

    Unlike your large intestine (colon), your small intestine normally has relatively few bacteria. But in blind loop syndrome, stagnant food in the bypassed small intestine becomes an ideal breeding ground for bacteria. The bacteria may produce toxins as well as block the absorption of nutrients.

    The greater the length of small bowel involved in the blind loop, the greater the chance of bacterial overgrowth.

    What triggers blind loop syndrome?

    Blind loop syndrome can be caused by:

    • Complications of abdominal surgery, including gastric bypass for obesity and gastrectomy to treat peptic ulcers and stomach cancer
    • Structural problems in and around your small intestine, including scar tissue (intestinal adhesions) on the outside of the bowel and small, bulging pouches of tissue that protrude through the intestinal wall (diverticulosis)
    • Certain medical conditions, including Crohn's disease, radiation enteritis, scleroderma, celiac disease, obesity and diabetes, can slow movement (motility) of food and waste products through the small intestine

    Source: http://www.mayoclinic.com


    The first step in diagnosing blind loop syndrome is usually an imaging test, such as:

    • Abdominal X-ray
    • Abdominal CT scan

    You may have additional tests to check for bacterial overgrowth in your small intestine, poor fat absorption, or other problems that may be causing or contributing to your symptoms:

    • Barium X-ray of the small intestine. This test uses a contrast solution (barium) to coat the lining of your intestine so that it stands out clearly on X-rays. A barium X-ray may reveal a blind loop, diverticulosis, a narrowing (stricture) of the intestine or other structural problems, as well as slow transit times that can cause bacterial overgrowth.
    • CT enterography. This test is more sensitive than is a barium X-ray or conventional CT. It helps detect inflammation or structural problems in the bowel and abnormalities in other organs, such as the pancreas.
    • Hydrogen breath test. This test measures the amount of hydrogen that you breathe out after drinking a mixture of glucose and water. A rapid rise in hydrogen indicates poor carbohydrate digestion and bacterial overgrowth in your small intestine. Although widely available, this test is less sensitive than other breath tests.
    • D-xylose breath test. This test, which is more accurate than a hydrogen breath test, measures the amount of carbon dioxide in your breath. High levels of carbon dioxide suggest bacterial overgrowth.
    • Bile acid breath test. Bile acids from your liver help digest fats (lipids) in your small intestine. Bacterial overgrowth interferes with the process. This test uses a bile salt with a radioactive tracer to check for bile salt dysfunction.
    • Quantitative fecal fat test. This test can determine how well your small intestine absorbs fat. You eat a high-fat diet for three days, and the amount of fat in your stool is then measured. Large amounts of undigested fat may be caused by bacterial overgrowth, but more commonly result from other conditions such as short bowel syndrome or chronic pancreatitis.
    • Small intestine aspirate and fluid culture. This is the most sensitive test for bacterial overgrowth. To obtain the fluid sample, doctors pass a long, flexible tube (endoscope) down your throat and through your upper digestive tract to your small intestine. A sample of intestinal fluid is withdrawn and then tested in a laboratory for the growth of bacteria.

    If your doctor believes that bacterial overgrowth is very likely, he or she may begin treatment with antibiotics immediately without specific testing.

    Source: http://www.mayoclinic.com


    A blind loop can cause escalating problems, including:

    • Poor absorption of fats. Bacteria in your small intestine break down the bile salts needed to digest fats. As a result, your body can't fully absorb the fat-soluble vitamins A, D, E and K. Incomplete absorption of fats leads to diarrhea, weight loss and vitamin deficiency disorders.
    • Damage to the intestinal lining. Toxins that are released when bacteria break down stagnant food harm the mucous lining (mucosa) of the small intestine. As a result, most nutrients, including carbohydrates and proteins, are poorly absorbed, leading to serious malnourishment.
    • Vitamin B-12 deficiency. Bacteria in the small intestine absorb vitamin B-12, which is essential for the normal functioning of your nervous system and the production of blood cells and DNA. A severe B-12 deficiency can lead to weakness, fatigue, tingling and numbness in your hands and feet, and, in advanced cases, to mental confusion. Damage to your central nervous system resulting from a B-12 deficiency may be irreversible.
    • Brittle bones (osteoporosis). Over time, damage to your intestine from abnormal bacterial growth causes poor calcium absorption, and eventually may lead to bone diseases, such as osteoporosis.
    • Kidney stones. Poor calcium absorption may also eventually result in kidney stones.

    Source: http://www.mayoclinic.com

    Risk factors

    Factors that increase your risk of blind loop syndrome include:

    • Gastric surgery for obesity or ulcers
    • A structural defect in the small intestine
    • An injury to the small intestine
    • An abnormal passageway (fistula) between two segments of bowel
    • Crohn's disease, intestinal lymphoma or scleroderma involving the small intestine
    • History of radiation therapy to the abdomen
    • Diabetes
    • Diverticulosis of the small intestine

    Source: http://www.mayoclinic.com

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