Is a proliferation of colonic-type bacteria within small intestine caused disorder with diarrhea, steatorrhea, and macrocytic anemia. The syndrome was suspected from the combination of a low serum cobalamin level and elevated serum folate leve.
Diagnosed by the demonstration of increased levels of aerobic and/or anaerobic colonic-type bacteria in a jejunal aspirate obtained by intubation. Breath hydrogen testing with administeration of lactulose( a nondigestible disaccharide) had been used to diagnose this symdrome. The treatment was antibiotics that tetracyclin was first choice for ~3weeks until symptom remit.
Reference: Harrisons_Principles_of_Internal_Medicine,_19th_Edition
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