Trip Answers

Question answered:01/07/07 Warning! this question is over two years old.

There was not a great deal of information on this topic.

 

GP Notebook has a chapter on bacterial overgrowth, giving duodeno-jejunal diverticulae as a possible cause.  In relation to management it reports:

 

“- broad spectrum antibiotics - E. coli is the most common organism and is sensitive to ampicillin, 250 mg qds, or tetracycline, 250 mg qds
 - vitamin B12 replacement - 1 mg i.m. for 5 days
 - surgical correction of the affected small bowel segment”

 

Both eMedicine [2] and the Merck Manual [3] have chapters on Bacterial Overgrowth Syndrome, both report antibiotics as the treatment.

 

We found two RCTs of probiotics in relation to bacterial overgrowth.  A 2006 trial looked at bacterial overgrowth in relation to IBS [4], this concluded:

 

“The increased colonisation by Bifi-dobacterium longum W11, after the cyclic administration of rifaximin, which eradicates the bacterial overgrowth of the small intestine, may reduce symptoms, especially those related to bowel habit and stool frequency in patients with IBS. The abnormalities observed in the colonic flora of IBS suggest, in fact, that a probiotic approach will ultimately be justified.”

 

A 2002 paper “Effect of Lactobacillus strains (L. casei and L. Acidophillus Strains cerela) on bacterial overgrowth-related chronic diarrhea.” [5] reported:

 

“In summary, this study provides evidence that LC are effective for treatment of bacterial overgrowth--related chronic diarrhea, and suggest that probiotics must be used with continuity.”

 

References

1) http://www.gpnotebook.co.uk/simplepage.cfm?ID=-2006253529
2) http://www.emedicine.com/med/topic198.htm
3) http://www.merck.com/mmpe/sec02/ch017/ch017b.html
4) Fanigliulo L et al. Role of gut microflora and probiotic effects in the irritable bowel syndrome. Acta Biomed. 2006 Aug;77(2):85-9. (http://pmid.us/ 17172187)
5) Gaon D et al. Effect of Lactobacillus strains (L. casei and L. Acidophillus Strains cerela) on bacterial overgrowth-related chronic diarrhea. Medicina (B Aires). 2002;62(2):159-63. (http://pmis.us/ 12038039)
 

---

DISCLAIMER: TRIPanswers is a collection of clinical questions and answers.  Each provider will have their own methodology in answering questions and these are likely not to be as rigorous as systematic review.  If you have any doubt as to the implications of this contact the Q&A Service Provider for further information. This document is presented for information purposes only. This document cannot and should not be used as a basis of diagnosis or choice of treatment, and is in no way intended to replace professional medical care or attention by a qualified practitioner. TRIPanswers and TRIP Database Ltd are not responsible or liable for, directly or indirectly, ANY form of damage whatsoever resulting from the use/misuse of information contained in or implied by this document.  Also, ensure you have read the terms and conditions for using the site.