Blind loop syndrome patients presents with non-specific symptoms, such as nausea, lack of appetite, dyspepsia, flatulence, abdominal distention and pain, early satiety, diarrhea, steatorrhea, unintentional weight loss eventually leading to cachexia and nutrient deficiencies, such as vitamin B12, leading to megaloblastic anemia [1] or protein deficiency due to steatorrhea and malabsorption, causing peripheral edema [2]. In children, the physician will notice growth retardation. Although these findings are caused by due to different etiologies, in this case, they are due to the loss of defense mechanisms in the by-passed intestinal loop [3] [4] and to the decreased absorption surface. A high level of suspicion should be raised in the patients who underwent abdominal surgery, especially gastroenterostomy or Billroth II gastric resection.

Symptoms develop gradually, over a long period of time and also consist of other vitamin deficiency signs, such as blepharitis, glossitis, and cheilosis, neurologic abnormalities: decreased proprioception and deep tendon reflexes [5] and additional digestive signs, like bilious vomiting [5], caused by convulsive emptying of the blind loop.

• Anorexia

  Dominguez LF 32482516 2020 18 [Association of thermal food processing methods and small intestinal bacterial overgrowth syndrome]. 62 Pilipenko VI...Morozov SV 32790263 2020 19 Microbiota, Microbial Metabolites, and Barrier Function in A Patient with Anorexia [malacards.org]

• Steatorrhea

  Ingestion of an excess of fat leads to steatorrhea. As a side-effect, malabsorption of iron, calcium and other elements can occur causing anemia and hypocalcemia. The blind loop syndrome gives the same symptoms. [ncbi.nlm.nih.gov]

  […] nutrient deficiencies, such as vitamin B12, leading to megaloblastic anemia or protein deficiency due to steatorrhea and malabsorption, causing peripheral edema. [symptoma.com]

  Bacterial breakdown of bile salts and deamination of protein lead to malabsorption, steatorrhea, and fat-soluble vitamin deficiencies. [jpedsurg.org]

• Loss of Appetite

  ADVERTISEMENT Advertisement Symptoms Symptoms include: Diarrhea Fatty stools Fullness after a meal Loss of appetite Nausea Unintentional weight loss Exams and Tests During a physical exam, the health care provider may notice a mass in, or swelling of [healthing.ca]

  The patient may also experience diarrhea, nausea, loss of appetite, weight loss, cramps, growth retardation etc. [natural-homeremedies.org]

  […] of appetite Nausea Flatulence Diarrhea Fullness after a meal Fatty stools (steatorrhea) Unintentional weight loss Generalised weakness Diagnosis Of Blind Loop Syndrome: The following tests help in diagnosing blind loop syndrome: Abdominal X-ray Abdominal [natural-health-news.com]

  Symptoms Loss of appetite Nausea Diarrhea Fullness after a meal Fatty stools Unintentional weight loss Signs and tests A physical examination may reveal a mass or distention of the abdomen. [bionity.com]

  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 When to see a doctor Bloating, nausea and diarrhea are signs [fortishealthcare.com]

• Intestinal Disease

  From Wikidata Jump to navigation Jump to search intestinal disease characterized by a dysbalance of the bacterial flora of the small intestine, causing derangement to the normal physiological processes of digestion and absorption Bacterial overgrowth [wikidata.org]

  […] pathologie Malabsorption intestinale Keyword (en) Blind loop syndrome Surgery Complication Case study Human Digestive diseases Intestinal disease Intestinal malabsorption Keyword (es) Asa ciega síndrome Cirugía Complicación Estudio caso Hombre Aparato [pascal-francis.inist.fr]

  including Crohn’s disease, radiation enteritis, scleroderma, celiac disease, obesity and diabetes, can slow movement (motility) of food and waste products through the small intestine Diseases such as diabetes or scleroderma may slow down movement in [healthjade.net]

• Abdominal Distension

  Abdominal examination may reveal cachexia, abdominal distension and evidence of vitamin and mineral deficiencies. Investigations SIBO can be diagnosed by:[5] Culture of jejunum aspirate for bacterial counts. 14C-D-xylose breath testing. [patient.info]

  My primary symptoms were chronic constipation and bloating or abdominal distension no matter what I ate. After the first round I felt great...better than I had felt in months. Then the symptoms returned. #8 Xifaxan didn't do shit for me. [bariatricfacts.org]

  The patient complained of abdominal distension and had an abnormal serum biochemistry caused by blind loop syndrome related to childhood abdominal surgery. [ekjm.org]

• Delayed Gastric Emptying

  Decreased motility of the small intestine [1,2] : Neurological disorders: diabetic autonomic neuropathy with delayed gastric emptying (gastroparesis), myotonic dystrophy, Parkinson disease, Chagas enteropathy Infiltration of the small intestinal wall: [nutrientsreview.com]

  gastric emptying/gastroparesis Internal or enterocutaneous fistulae Small bowel obstruction Dumping syndrome Alkaline reflux gastritis Roux stasis syndrome Cardiac arrhythmias Deep venous thrombosis Pulmonary embolism Locke GR, Alexander GL, Sarr MG. [emedicine.medscape.com]

  gastric emptying, and reduced intestinal motility is common in diabetes. [todaysdietitian.com]

• Osteoporosis

  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. [fortishealthcare.com]

  The bacterial overgrowth which may cause poor absorption of calcium could lead to osteoporosis or other bone diseases. [epharmapedia.com]

  If untreated, the clinical course progresses to malabsorption of fats, vitamin B12 and calcium, the latter which predisposes to nephrolithiasis and osteoporosis. [ NCIT : P378 ] Synonyms: Blind loop syndrome (disorder) blind loop syndrome bacterial overgrowth [ebi.ac.uk]

The first step in diagnosing blind loop syndrome is to do an abdominal radiograph, which will show a nonspecific gas collection; this aspect may be absent if the loop is not empty. Barium fluoroscopy may bring additional information in this case, as well as exclude intestinal diverticulosis or strictures. Thus, barium can enter a limited portion of the afferent loop, not enter it at all or enter and then be propelled back into the stomach [1].

A computer tomography will help observe the anastomosis and an adjacent dilated intestinal loop, that may be filled with feces, leading to a difficult imaging differential diagnosis with small bowel obstruction or abscess [6]. Abdominal computer tomography and computer tomography enterography also provide information about neighboring structures, such as the pancreas.

Hydrogen breath test is used to measure the level of exhaled hydrogen; if high, this suggests carbohydrate maldigestion and bacterial overgrowth syndrome, a complication of the blind loop. This can also be diagnosed using D-xylose breath test, that measures the exhaled carbon dioxide level.

Steatorrhea dictates the need for a quantitative fecal test, also an indicator of small intestinal bacterial overgrowth syndrome, chronic pancreatitis or short bowel syndrome. Bile acid breath test can also be performed, in order to identify bile dysfunction. If small intestinal bacterial overpopulation is still uncertain at this point, a small intestinal aspirate and culture need to be performed, having in mind that this is the diagnosis gold standard in this instance.

Absorption of various nutrients being impaired in blind loop syndrome, various malabsorption diagnosis techniques has been developed. Co60-tagged vitamin B12 urinary and fecal excretion and hepatic uptake are examples of these methods [7] [8] [9]. If urinary vitamin B12 is diminished, the test is repeated after intrinsic factor is administered. If urinary excretion becomes normal, the diagnosis is pernicious anemia, probably caused by gastric atrophy, and blind loop syndrome is disproved. Gastric fluid analysis and gastric biopsy may also be helpful in certain cases.

• Macrocytic Anemia

  Pathogenesis and treatment of macrocytic anemia. Arch. Int. Med. 1956; 96: 541 Scopus (33) Crossref Google Scholar MacLean L.D. Incidence of megaloblastic anemia after subtotal gastrectomy. New England J. [amjmed.com]

  Vitamin B12 deficiency may cause macrocytic anemia in which the average size of erythrocytes is larger than normal. Bacterial growth may also cause inflammation in the intestinal walls and this impairs the absorption of carbohydrates and protein. [natural-homeremedies.org]

  The macrocytic anemia appears related to binding of vitamin B12 by metabolites of Escherichia coli, and treatment with antibiotics frequently gives striking relief (7). [pubs.rsna.org]

  […] with weakness and paleness [1] Impaired vitamin B12 and folate absorption resulting in macrocytic anemia and neuropathy with paleness, tingling or numbness [1,4] Impaired selenium absorption resulting in dermatitis [1] Other Possible Complications of [nutrientsreview.com]

  The experimental production of macrocytic anemia by operation of the intestinal tract. Blood 1949; 4:803–815. 4. Kim TH, Kim JK, Song SY, et al. A case of amyloidosis associated with malignant lymphoma, presenting as a Malabsorption syndrome. [ekjm.org]

• Neutropenia

  33129166 2021 14 Small Intestinal Bacterial Overgrowth Syndrome: A Guide for the Appropriate Use of Breath Testing. 62 Massey BT...Wald A 33037967 2021 15 Acquired Hyperzincaemia Due to Zinc-Laden Denture Adhesives Leading to Hypocupraemia as a Cause of Neutropenia [malacards.org]

• Giardia Lamblia

  Castro M, Sánchez Porto A, Guillén P, Martín E, Guerrero P, Vargas J: Malabsorption syndrome caused by Giardia lamblia in gastrectomized patients (in Spanish). Enferm Infecc Microbiol Clin 1989;7:100-102. [karger.com]

Treatment: Intermittent or continuous antibiotic treatment is the first-line therapy. In addition vitamin B 12 replacement is required. [doi.org]

Possible tests include: Abdominal CT scan Abdominal x-ray Blood tests to check nutritional status Upper GI series with small bowel follow through contrast x-ray Treatment Treatment most often starts with antibiotics for the excess bacteria growth, along [healthing.ca]

However, the BLS is not always reversible that is why some treatment options focus on getting rid of bacterial overgrowth and correcting nutritional deficiencies. [syndromespedia.com]

Testing may then be performed when antibiotic treatment becomes ineffective. [findatopdoc.com]

Tetracyclines have been the mainstay of treatment for blind loop syndrome, but recent studies have concluded rifaximin to be very effective in the treatment of blind loop syndrome. [en.wikipedia.org]

Outlook (Prognosis) Many people get better with antibiotics. If surgical repair is needed, the outcome is often very good. [healthing.ca]

Prognosis A lot of patients are cured completely with antibiotics. If surgical treatment is needed per evaluation, it can have a very good prognosis outcome. [syndromespedia.com]

[…] distended segment of bowel at the anastomosis surgical clips are usually adjacent to the pouch pouch may be filled with fluid or fecal material A blind loop or blind pouch may be misinterpreted as an abscess or small bowel obstruction Treatment and prognosis [radiopaedia.org]

Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Blind loop syndrome from other Diseases Epidemiology and Demographics Risk Factors Screening Natural History, Complications and Prognosis [wikidoc.org]

Mots-clé Adult, Anastomosis, Surgical, Appendectomy, Blind Loop Syndrome/diagnosis, Blind Loop Syndrome/etiology, Diagnosis, Differential, Female, Humans, Ileum/surgery, Male, Postoperative Complications/diagnosis, Postoperative Complications/etiology [serval.unil.ch]

These studies demonstrate (a) significant protein loss as one etiologic factor for protein metabolic disturbances in the human and experimental rat blind-loop syndrome, (b) the occurrence of intestinal protein loss as a manifestation of functionally significant [ncbi.nlm.nih.gov]

Although these findings are caused by due to different etiologies, in this case, they are due to the loss of defense mechanisms in the by-passed intestinal loop and to the decreased absorption surface. [symptoma.com]

However, because bacterial overgrowth can mimic other malabsorptive disorders (eg, Crohn disease) and adverse effects of the antibiotics can worsen symptoms of diarrhea, establishing a definitive etiology is preferred. [msdmanuals.com]

Patient Epidemiology Analysis The blind loop syndrome market also provides you with detailed market analysis for patient analysis, prognosis and cures. [databridgemarketresearch.com]

The epidemiology of venous thromboembolism (VTE) in the community has important implications for VTE prevention and… Lidocaine block of cardiac sodium channels was studied in voltage-clamped rabbit purkinje fibers at drug concentrations ranging… BURG, [semanticscholar.org]

Blind loop syndrome Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Blind loop syndrome from other Diseases Epidemiology and Demographics Risk Factors Screening Natural History [wikidoc.org]

Epidemiology Sex : ♂ > ♀ Peak incidence : 70 years Geographical distribution : strong regional differences High incidence in South Korea and Japan Declining incidence in the United States and Europe References: [1] [2] Epidemiological data refers to the [amboss.com]

Peptic ulcer surgery during the H2-receptor antagonist era: a population-based epidemiological study of ulcer surgery in Helsinki from 1972 to 1987. Br J Surg. 1991 Jan. 78(1):28-31. [Medline]. Tovey FI, Godfrey JE, Lewin MR. [emedicine.medscape.com]

This paper presents a review of control strategies, stability analysis, and stabilization techniques for dc microgrids (MGs… RATIONALE The pathophysiologic causes of obstructive sleep apnea (OSA) likely vary among patients but have not been well… A novel [semanticscholar.org]

PAK Major progress has been made in the pathophysiologic elucidation and management of nephrolithiasis during the past two decades. [books.google.com]

Blind loop syndrome Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Blind loop syndrome from other Diseases Epidemiology and Demographics Risk Factors Screening Natural History [wikidoc.org]

Current concept of pathophysiology. Surgery 73: 639, 1973 Google Scholar 6. Bayes BJ, Hamilton TR: Blind loop syndrome in children with malabsorption secondary to intestinal anastomosis Arch Dis Child 44: 76, 1969 PubMed CrossRef Google Scholar 7. [link.springer.com]

Another cause is jejunoileal diverticula.[2] Pathophysiology[edit] The overgrowth of bacteria in the small intestine is prevented by various mechanical and chemical factors which include the constant peristaltic movement of contents along the length of [en.wikipedia.org]

Secondary Prevention Cost-Effectiveness of Therapy Case Studies Case #1 Blind loop syndrome other imaging findings On the Web Most recent articles Most cited articles Review articles CME Programs Powerpoint slides Images American Roentgen Ray Society [wikidoc.org]

This prevents fat and fat-soluble vitamins from being absorbed into the body. It also leads to fatty stools. Vitamin B12 deficiency may occur because the extra bacteria that form in the blind loop use up this vitamin. [healthing.ca]

The epidemiology of venous thromboembolism (VTE) in the community has important implications for VTE prevention and… Lidocaine block of cardiac sodium channels was studied in voltage-clamped rabbit purkinje fibers at drug concentrations ranging… BURG, [semanticscholar.org]

1. Goldstein F, Wirts C, Kramer S.The relationship of afferent limb stasis and bacterial flora to the production of postgastrectomy steatorrhea. Gastroenterology. 1961;40():47-55.
2. Naish J, Capper W. Intestinal cul-de-sac phenomena in man. Lancet. 1953;265(6786):597-600.
3. Elphick DA, Chew TS, Higham SE, Bird N, Ahmad A, Sanders DS. Small bowel bacterial overgrowth in symptomatic older people: can it be diagnosed earlier? Gerontology. 2005;51:396–401.
4. Iivonen MK, Ahola TO, Matikainen MJ. Bacterial overgrowth, intestinal transit, and nutrition after total gastrectomy. Comparison of a jejunal pouch with Roux-en-Y reconstruction in a prospective random study. Scand J Gastroenterol. 1998;33:63–70.
5. Adams J. Postgastrectomy megaloblastic anaemia and the loop syndrome.Gastroenterologia. 1958; 89(5-6):326-30
6. Sandrasegaran K, Maglinte DD, Rajesh A, et al. CT findings for postsurgical blind pouch of small bowel. AJR Am J Roentgenol. 2006;186 (1): 110-113.
7. Heinle R, Welch A, Scharf V, et al. Studies of excretion (and absorption) of Co60 labeled vitamin B12 in pernicious anemia. Trans Assoc Am Physicians. 1952; 65():214-222
8. Glass G, Boyd L, Stephanson L. Intestinal absorption of vitamin B12 in humans as studies by isotope technic. Proc Soc Exp Biol Med. 1954;86(3):522-526.
9. Schilling R. Intrinsic factor studies II. The effect of gastric juice on the urinary excretion of radioactivity after the oral administration of radioactive vitamin B12. J Lab Clin Med. 1953;42(6):860-866.