Increased bacterial colonization of the small bowel proximal to the distal ileum .
Presentation: Wt loss, abd pain, diarrhea and mal nutrition.
Late presentation include neurlogical symptoms due to vit B12 and fat soluable vitamins malabsorption.
Causes:
1- Reduce host defence:
Hypogammaglobulinaemia
HIV
Old age
Chronic pancreatitis
2-Excessive bacterial entery to the small bowel:
Atrophic gastritis/ gastric acid suppression
Gastro-jujunostomy
Gastrectomy
Entral fistula
3-Delayed small bowel clearance:
Small bowel/ jujunal diverticula
Scleroderma
Strictures (CD, post surgical)
Pseudo-obstruction
Amyloidosis
Autonomic neuropathy (DM)
Diagnosis:
1-Culture of duodenal aspirate - bacteria level > 10 5 colonoies/ ml
2-Hydrogen breath test ( non-invasive)
I was diagnosed as HEPATITIS B carrier in 2013 with fibrosis of the
ReplyDeleteliver already present. I started on antiviral medications which
reduced the viral load initially. After a couple of years the virus
became resistant. I started on HEPATITIS B Herbal treatment from
ULTIMATE LIFE CLINIC (www.ultimatelifeclinic.com) in March, 2020. Their
treatment totally reversed the virus. I did another blood test after
the 6 months long treatment and tested negative to the virus. Amazing
treatment! This treatment is a breakthrough for all HBV carriers.