With the syndrome of excessive bacterial growth in the intestine, the number of bacteria that represent the normal microflora increases. This rarely leads to gastroenterological diseases and does not directly affect the patient's lifespan.
In some cases, pathogens may appear. But, as a rule, this does not negatively affect the quality of life, but bloating, gas formation, heartburn, nausea and other constant manifestations of SIBR. A set of symptoms can occur after various surgical interventions, with impaired motility or a change in the level of acidity.
Description of SIBR
Normally, the mass of bacteria in the intestines of an adult is about 2.5 kg. Moreover, the total genome includes 400 thousand genes, which is 12 times the size of the human genome. About 100 microorganisms per 1 ml live in the small intestine. In the intestinal flora of the large intestine, their number is much higher - 1010-1012 per 1 ml. Most of the microorganisms are destroyed by acid in the stomach. Partly microflora is represented by opportunistic organisms. Bacteria also have a physiological function: in the process of fermentation, they break down food. In total, there are from 500 to 1,000 different strains of microorganisms living in the digestive tract.
With the syndrome of excessive bacterial growth in the small intestine, microorganisms appear that are qualitatively and quantitatively similar to the microflora of the large intestine. As a result, the inflammatory process develops, the functional work of the entire digestive tract is disrupted. Microorganisms metabolize vitamins, which leads to malnutrition. Bacteria activate the premature process of divergence of acid salts, contributing to malabsorption and deficiency of nutrients. Also, with excessive bacterial growth in the small intestine, patients experience pathological changes in the mucosa. This can lead to other diseases of the digestive system.
So what is bacterial overgrowth syndrome? This is a pathological condition characterized by a change in microflora in the small intestine. The syndrome leads to functional disorders in the digestive system, which is manifested by a number of symptoms. Most often, patients experience diarrhea and disrupt the transport of nutrients. Usually (but not necessarily) the syndrome of excessive bacterial growth in the intestine occurs against the background of another disease.
Risk factors
At risk for the development of the syndrome of excessive bacterial growth in the intestine are young children (including newborns, whose gastrointestinal tract is only just beginning to be colonized by bacteria) and older people. According to statistics, SIBR develops in approximately 20-43% of patients with diabetes.
A set of symptoms is also characteristic for people with eating disorders and eating disorders. Bulimia, anorexia, periodic episodes of overeating, irregular and irrational nutrition with a deficiency of vitamins and nutrients can also lead to excess bacterial growth syndrome (SIBR).
In half the cases, the cause of neonatal chronic diarrhea is precisely SIBR. Microflora can also change after taking a course of antibiotics, with nutritional disorders (for example, eating foods that are not of age), intestinal infections and lactase deficiency.
The following phenomena also contribute to the occurrence of an excess bacterial growth syndrome in the intestine (symptoms will be described later):
- anatomical changes that contribute to a delay in the passage of contents along the gastrointestinal tract;
- lack of an ileocecal valve;
- short bowel syndrome ;
- various disorders of peristalsis;
- increased secretion of hydrochloric acid;
- disorders of the immune system;
- the use of certain pharmaceutical preparations (for example, proton pump inhibitors that inhibit the secretion of hydrochloric acid).
Main symptoms
The clinical picture of the disease is diverse. Among the symptoms of the syndrome of excessive bacterial growth in the intestines, doctors distinguish abdominal (associated with the abdominal cavity) and general. The abdominal manifestations include:
- flatulence (rumbling in the abdomen, bloating) that occurs after a small interval after eating;
- irregular stools with frequent bouts of diarrhea;
- the presence of undigested food particles in the feces.
Rarely, patients experience nausea.
Common symptoms include:
- a variety of neurotic disorders (frequent mood changes, hysteria, anxiety, insomnia);
- weight loss;
- signs of deficiency of iron, folic acid, vitamins D, K, A, E.
The latter also has its symptoms, expressed:
- general weakness and drowsiness throughout the day;
- fatigue;
- visual impairment;
- frequent headaches and dizziness;
- decreased visual acuity;
- dry skin.
Possible signs of impaired blood formation. Children may experience stunted growth.
What is the danger of bacterial overgrowth syndrome? All characteristic symptoms of SIRB do not threaten the patient's life, but negatively affect its quality. Over time, psychological and other health problems can be added, because all processes in the human body are interconnected.
Forms of the disease
Depending on the amount and nature of microflora, doctors distinguish three forms of the disease. The first degree of SIBR is characterized by an increase in aerobic microflora (bacteria predominate, for which vital air is needed). In the second stage, anaerobic microorganisms appear. These are those who do not need oxygen access for a normal existence. The third stage is characterized by the predominance of anaerobic microflora in the digestive tract.
Diagnostic Methods
Diagnosis and treatment of the syndrome of overgrowth of bacteria in the intestine begins with an assessment of the patient’s general health, because, as a rule, SIBR is caused by concomitant diseases or appears due to eating disorders. Often the cause of SIBR, for example, may be irritable bowel syndrome - a functional disorder accompanied by bloating, abdominal pain, discomfort in the absence of structural lesions of the gastrointestinal tract. In half the cases, this diagnosis leads to enhanced bacterial growth.
The doctor must exclude:
- malfunctioning valve;
- diseases associated with intestinal motility disorders;
- prolonged food imbalance;
- inflammatory diseases of the digestive tract (especially chronic);
- short bowel syndrome;
- immune disorders (local and systemic, including chemical or radiation exposure, AIDS);
- bacteria from the extraintestinal reservoir;
- taking antibiotics by the patient;
- intestinal tumors.
A negative effect is exerted by cleansing with enemas and various diets. Syndrome of excessive bacterial growth in the intestine can also be caused by stresses of various origins.
SIBR should be suspected in patients who complain of uncontrolled weight loss, flatulence, bloating, discomfort, and frequent diarrhea. Diagnosis is by microflora culture. For this purpose, the contents of the intestine are aspirated with culture on a nutrient medium.
Sowing feces, which is widely used in domestic medicine, is already recognized as uninformative in international practice, since it can give an idea of only 12-15 types of bacteria. This method, however, can be used to identify specific infectious pathogens.
The diagnosis is made after a hydrogen breath test with glucose and lactose. Both studies are usually tolerated easily by patients. It is necessary to drink a sugar solution, after which the hydrogen content in the exhaled air is determined. In a milk sugar test, blood glucose is additionally evaluated. Increased rates indicate excessive gas formation. Together with a breath test, a study of the secretion of the jejunum can be carried out.
Additionally, a general blood test is shown. Indicate SIBR and anemia may:
- reduced hemoglobin (with excessive bacterial growth decreases due to malabsorption of B12 and iron);
- low protein;
- decreased albumin levels.
Due to malabsorption of glucose, blood sugar levels may decrease.
For dermatological problems in combination with gastrointestinal symptoms, a test for selenium content is especially important. Confirms SIBR deficiency of this element. The exact scope of the examination is determined by the attending physician on the basis of the medical history and medical history.
SIBR treatment
After determining the exact diagnosis, the doctor is faced with the question of choosing treatment tactics. The syndrome of excessive bacterial growth in the intestine suggests:
- antibiotic therapy;
- if necessary, taking probiotics and prebiotics to restore normal gastrointestinal microflora;
- antidiarrheal and analgesics according to indications.
In the treatment regimen, it is necessary to include measures for stopping the underlying disease. How to treat enhanced bacterial growth syndrome? A therapeutic diet can lead to an improvement in the patient's condition. Surgical treatment is sometimes necessary: if SIBR has developed against the background of anatomical pathologies of the structure of the digestive system.
After a course of antibiotics that lasts at least two weeks, it is recommended that the patient be observed for several months. In this case, the best results can be achieved if the focus is not on eliminating the symptoms, but on the therapy of the underlying disease.
Additional guidelines for managing patients with bacterial overgrowth syndrome:
- "Tetracycline" is usually effective if the syndrome is not idiopathic (of unknown origin);
- patients with diabetes are prescribed Amoxicillin or clavulanic acid;
- elderly patients are recommended Metronidazole and Clindamycin;
- "Gentamicin" (judging by the reviews of parents) improves the health status of children up to a year.
The listed drugs can be produced under different trade names. Gentamicin, for example, is Gentamine, Amgent, Gentsin, Septopal, and Gentamisin. Indicated for use in bacterial infections. Contraindications are hypersensitivity, the period of neonatality and prematurity, lactation and old age. In some cases, it can be used for infants less than one week old. This is an antibacterial drug for intramuscular or intravenous administration, so self-medication is strictly contraindicated. All of the above medicines are purchased only by prescription.
Special diet
During treatment, it is very important for the patient to follow the therapeutic regimen developed by the doctor and take the medicine in exact dosages. Judging by the reviews, a deviation from the tactics of therapy can not only not give any positive results, but also lead to disastrous consequences. In addition, stress should be avoided, eat fractionally and exclusively on the treatment menu.
Diet should be based on foods that are easily digestible. You need to avoid sweeteners, limit sugar, refuse dairy products, drink at least eight glasses of pure water per day, use the recommended amount of protein (120-140 grams of beef or poultry per day).
Be sure to include in the diet fresh, boiled or slightly stewed vegetables, fruits in moderation, which will normalize the stool. Rice (other than wild), pasta, bread and potatoes are acceptable. But for each meal should be no more than half a cup of these products.
Possible complications
With a prolonged course, the syndrome of excessive bacterial growth leads to a deficiency of vitamins and minerals. Anemia can develop that is triggered by a lack of vitamin B12.
Usually SIBR is not an independent disease, so the complications and prognosis largely depend on the underlying pathology that led to its formation. If it is not eliminated, then unpleasant symptoms from the gastrointestinal tract will regularly recur.
Prevention
Successful treatment of the syndrome of excessive bacterial growth in the intestine usually begins with a differential diagnosis and identification of concomitant diseases, because SIBR is rarely an independent pathology. For this reason, the main preventive measure is the timely detection and appropriate treatment of any infectious and non-infectious diseases of the gastrointestinal tract, the regular monitoring of a doctor in case of digestive problems and following all the doctor's recommendations.
Patients (especially those at risk) are recommended in everyday life to follow the rules of good nutrition, not to overeat and not to starve, abandon strict diets for weight loss and home bowel cleansing, which usually do not lead to anything good. It is advisable not to allow stress, to monitor the maintenance of the normal functioning of the immune system and to ensure sufficient physical activity. These are the general rules of a healthy lifestyle.
Finally
Description, diagnosis and treatment of the syndrome of excessive growth of bacteria in the intestine have been discussed in detail above. The clinical symptoms of the syndrome are non-specific, but can cause significant disruption of the entire digestive system. Diagnostic methods are used predominantly non-invasive. Treatment of the syndrome of excessive bacterial growth in the small intestine is carried out with the use of antibiotics, probiotics, adherence to a therapeutic diet, correction of eating habits and therapy of the underlying disease. Judging by the reviews of patients, the prognosis is usually entirely determined by the course of the pathology that caused SIRB.