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Dysbacteriosis is a disorder of the intestinal bacterial flora. Dysbacteriosis occurs when the bacteria that colonize the large intestine pass into the small intestine. The main symptoms of bacterial flora disorders are symptoms from the digestive system: abdominal pain, flatulence or diarrhea. However, dysbacteriosis also leads to malabsorption, which can have serious he alth consequences.

Dysbacteriosis , orbacterial overgrowth , is a state of excessive growth in the small intestine of bacteria that colonize the large intestine under physiological conditions .

You should know that the bacterial flora changes its composition depending on its location in the digestive tract. A small amount of mainly aerobic bacteria is present in the stomach, duodenum and jejunum.

In subsequent sections of the intestine the amount of bacteria increases and anaerobic bacteria are more common. Under physiological conditions, changes in the growth of the bacterial flora are prevented by the low pH of gastric juice, intestinal motility, the presence of the ileocecal valve, mucus and secretory IgA.

Malfunctioning of these defense mechanisms leads to an overgrowth of bacteria in the small intestine, which consume vitamin B12, leading to its deficiency and produce enzymes that damage the intestinal villi. The bile s alts are also deconjugated, which results in impaired digestion of fats.

Dysbacteriosis - risk factors

The following factors contribute to the occurrence of dysbacteriosis:

  • anatomical defects impeding the efficient removal of bacteria from the intestine: diverticulum, duplication, "blind loop", intestinal narrowing,
  • diseases with motor disorders, such as: pseudo-obstruction syndrome, diabetic autonomic neuropathy, systemic scleroderma,
  • lesions that allow a large number of bacteria to enter the small intestine, for example: achlorhydria, intestinal fistulas, removal of the ileocecal valve, massive intestinal infection,
  • immunodeficiencies.

Chronic antibiotic therapy or long-term treatment with PPIs or H2 receptor blockers may be a factor that increases the risk of developing dysbacteriosis.

Dysbacteriosis - symptoms

The bacterial overgrowth syndrome manifests itself as:

  • chronic fatty diarrhea,
  • weight loss and malnutrition associated with digestive and absorption disorders,
  • abdominal pain, flatulence, feeling of overflow, excessive gas.

Due to the deficiencies of individual vitamins, the following may also occur:

  • osteomalacia and osteoporosis - related to vitamin D deficiency,
  • trophic epidermal disorders, night blindness - vitamin A deficiency,
  • megaloblastic anemia, ataxia and peripheral neuropathy - vitamin B12 deficiency.

Symptoms such as glomerulonephritis, hepatitis or fatty liver disease, dermatitis, and arthritis may also appear.

Dysbacteriosis - diagnosis

The following tests are useful in the diagnosis of the bacterial overgrowth syndrome:

  • laboratory tests that show macrocytic anemia and hypoalbuminemia,
  • X-ray of the gastrointestinal tract along with the assessment of the intestinal passage allows the detection of anatomical defects favoring dysbacteriosis,
  • microscopic examination of the stool shows an excessive amount of fat drops,
  • bacteriological culture of the intestinal contents from the proximal jejunum or duodenum proves an increased amount of anaerobic bacteria. The material for the examination is collected during endoscopy or with a tube inserted through the nose,
  • hydrogen breath tests or tests with D-xylose.

Dysbacteriosis - treatment

The use of drugs acting against aerobic and anaerobic gram-negative bacteria is essential. The drug of first choice is usually rifaximin. Additionally, vitamin deficiencies should be supplemented by appropriate supplementation.

You can also use cholestyramine, which binds free fatty acids and thus reduces the severity of diarrhea, prokinetic drugs, i.e. accelerating gastric emptying and intestinal transit, e.g. low dose erythromycin. Probiotics are also often used.

Nutritional therapy uses preparations containing medium-chain triglycerides to facilitate fat absorption.

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