Blind loop syndrome
Definition:
Blind loop syndrome occurs when part of the small intestine becomes bypassed. The "blind loop" formed by the bypassed intestine means food can't move normally through the digestive tract. The slowly moving food and waste products become a breeding ground for bacteria, which can lead to a condition called bacterial overgrowth. As a result, nutrients may not be fully absorbed. Blind loop syndrome often causes diarrhea and may cause weight loss and malnutrition.
Blind loop syndrome — sometimes called stasis syndrome or stagnant loop syndrome — often occurs as 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.
Symptoms:
Signs and symptoms of blind loop syndrome often include:
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:
Causes:
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:
A blind loop can cause escalating problems, including:
Treatments and drugs:
Whenever 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:
Definition:
Blind loop syndrome occurs when part of the small intestine becomes bypassed. The "blind loop" formed by the bypassed intestine means food can't move normally through the digestive tract. The slowly moving food and waste products become a breeding ground for bacteria, which can lead to a condition called bacterial overgrowth. As a result, nutrients may not be fully absorbed. Blind loop syndrome often causes diarrhea and may cause weight loss and malnutrition.
Blind loop syndrome — sometimes called stasis syndrome or stagnant loop syndrome — often occurs as 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.
Symptoms:
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
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
Causes:
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 extreme 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 and diabetes, can slow movement (motility) of food and waste products through the small intestine
Complications:
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 result in kidney stones.
Treatments and drugs:
Whenever 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.
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