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Blind loop syndrome

MedGen UID:
600
•Concept ID:
C0005750
•
Disease or Syndrome
Synonyms: Bacterial Overgrowth Syndrome; Blind Loop Syndrome; Loop Syndrome, Stagnant; Loop Syndromes, Stagnant; Stagnant Loop Syndrome; Stagnant Loop Syndromes; Syndrome, Bacterial Overgrowth; Syndrome, Blind Loop; Syndrome, Stagnant Loop; Syndromes, Stagnant Loop
SNOMED CT: Bacterial overgrowth syndrome (66379009); Contaminated small bowel syndrome (77225009); Stagnant loop syndrome (77225009); Blind loop syndrome (77225009)
 
Monarch Initiative: MONDO:0005673

Definition

A disorder affecting the small intestine. It is caused by the stasis of food and subsequent overgrowth of bacteria in a portion of the small intestine that is unintentionally bypassed as a complication of abdominal surgery or as a sequela of gastrointestinal disorders which impede effective motility. Clinical signs include bloating, abdominal pain, diarrhea and weight loss. If untreated, the clinical course progresses to malabsorption of fats, vitamin B12 and calcium, the latter which predisposes to nephrolithiasis and osteoporosis. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVBlind loop syndrome

Professional guidelines

PubMed

Absorbable vs. non-absorbable antibiotics in the treatment of small intestine bacterial overgrowth in patients with blind-loop syndrome.
Di Stefano M, Miceli E, Missanelli A, Mazzocchi S, Corazza GR
Aliment Pharmacol Ther 2005 Apr 15;21(8):985-92. doi: 10.1111/j.1365-2036.2005.02397.x. PMID: 15813834
Duodenal atresia and stenosis: reassessment of treatment and outcome based on antenatal diagnosis, pathologic variance, and long-term follow-up.
Grosfeld JL, Rescorla FJ
World J Surg 1993 May-Jun;17(3):301-9. doi: 10.1007/BF01658696. PMID: 8337875
Complications associated with surgical treatment of congenital intrinsic duodenal obstruction.
Spigland N, Yazbeck S
J Pediatr Surg 1990 Nov;25(11):1127-30. doi: 10.1016/0022-3468(90)90746-v. PMID: 2273425

Recent clinical studies

Etiology

Small Intestinal Bacterial Overgrowth-Pathophysiology and Its Implications for Definition and Management.
Bushyhead D, Quigley EMM
Gastroenterology 2022 Sep;163(3):593-607. Epub 2022 Apr 7 doi: 10.1053/j.gastro.2022.04.002. PMID: 35398346
AGA Clinical Practice Update on Small Intestinal Bacterial Overgrowth: Expert Review.
Quigley EMM, Murray JA, Pimentel M
Gastroenterology 2020 Oct;159(4):1526-1532. Epub 2020 Jul 15 doi: 10.1053/j.gastro.2020.06.090. PMID: 32679220
Small Intestinal Bacterial Overgrowth: Clinical Features and Therapeutic Management.
Rao SSC, Bhagatwala J
Clin Transl Gastroenterol 2019 Oct;10(10):e00078. doi: 10.14309/ctg.0000000000000078. PMID: 31584459Free PMC Article
The Spectrum of Small Intestinal Bacterial Overgrowth (SIBO).
Quigley EMM
Curr Gastroenterol Rep 2019 Jan 15;21(1):3. doi: 10.1007/s11894-019-0671-z. PMID: 30645678
Hydrogen and Methane-Based Breath Testing in Gastrointestinal Disorders: The North American Consensus.
Rezaie A, Buresi M, Lembo A, Lin H, McCallum R, Rao S, Schmulson M, Valdovinos M, Zakko S, Pimentel M
Am J Gastroenterol 2017 May;112(5):775-784. Epub 2017 Mar 21 doi: 10.1038/ajg.2017.46. PMID: 28323273Free PMC Article

Diagnosis

Small Intestinal Bacterial Overgrowth-Pathophysiology and Its Implications for Definition and Management.
Bushyhead D, Quigley EMM
Gastroenterology 2022 Sep;163(3):593-607. Epub 2022 Apr 7 doi: 10.1053/j.gastro.2022.04.002. PMID: 35398346
ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth.
Pimentel M, Saad RJ, Long MD, Rao SSC
Am J Gastroenterol 2020 Feb;115(2):165-178. doi: 10.14309/ajg.0000000000000501. PMID: 32023228
Small Intestinal Bacterial Overgrowth: Clinical Features and Therapeutic Management.
Rao SSC, Bhagatwala J
Clin Transl Gastroenterol 2019 Oct;10(10):e00078. doi: 10.14309/ctg.0000000000000078. PMID: 31584459Free PMC Article
The Spectrum of Small Intestinal Bacterial Overgrowth (SIBO).
Quigley EMM
Curr Gastroenterol Rep 2019 Jan 15;21(1):3. doi: 10.1007/s11894-019-0671-z. PMID: 30645678
Hydrogen and Methane-Based Breath Testing in Gastrointestinal Disorders: The North American Consensus.
Rezaie A, Buresi M, Lembo A, Lin H, McCallum R, Rao S, Schmulson M, Valdovinos M, Zakko S, Pimentel M
Am J Gastroenterol 2017 May;112(5):775-784. Epub 2017 Mar 21 doi: 10.1038/ajg.2017.46. PMID: 28323273Free PMC Article

Therapy

Alternative Treatment Approaches to Small Intestinal Bacterial Overgrowth: A Systematic Review.
Nickles MA, Hasan A, Shakhbazova A, Wright S, Chambers CJ, Sivamani RK
J Altern Complement Med 2021 Feb;27(2):108-119. Epub 2020 Oct 19 doi: 10.1089/acm.2020.0275. PMID: 33074705
AGA Clinical Practice Update on Small Intestinal Bacterial Overgrowth: Expert Review.
Quigley EMM, Murray JA, Pimentel M
Gastroenterology 2020 Oct;159(4):1526-1532. Epub 2020 Jul 15 doi: 10.1053/j.gastro.2020.06.090. PMID: 32679220
ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth.
Pimentel M, Saad RJ, Long MD, Rao SSC
Am J Gastroenterol 2020 Feb;115(2):165-178. doi: 10.14309/ajg.0000000000000501. PMID: 32023228
Small Intestinal Bacterial Overgrowth: Clinical Features and Therapeutic Management.
Rao SSC, Bhagatwala J
Clin Transl Gastroenterol 2019 Oct;10(10):e00078. doi: 10.14309/ctg.0000000000000078. PMID: 31584459Free PMC Article
How to Test and Treat Small Intestinal Bacterial Overgrowth: an Evidence-Based Approach.
Rezaie A, Pimentel M, Rao SS
Curr Gastroenterol Rep 2016 Feb;18(2):8. doi: 10.1007/s11894-015-0482-9. PMID: 26780631

Prognosis

Post-discharge follow-up of congenital duodenal obstruction patients: a systematic review.
Lum Min SA, Imam M, Zrinyi A, Shawyer AC, Keijzer R
Pediatr Surg Int 2023 Jul 25;39(1):239. doi: 10.1007/s00383-023-05515-w. PMID: 37490166
Show Me What You Have Inside-The Complex Interplay between SIBO and Multiple Medical Conditions-A Systematic Review.
Sroka N, Rydzewska-Rosołowska A, Kakareko K, Rosołowski M, Głowińska I, Hryszko T
Nutrients 2022 Dec 24;15(1) doi: 10.3390/nu15010090. PMID: 36615748Free PMC Article
Gastrointestinal toxicity of systemic oncology immunotherapy.
Bureš J, Kohoutová D, Zavoral M
Klin Onkol 2022 Fall;35(5):346-357. doi: 10.48095/ccko2022346. PMID: 36443091
Small Intestinal Bacterial Overgrowth: Clinical Features and Therapeutic Management.
Rao SSC, Bhagatwala J
Clin Transl Gastroenterol 2019 Oct;10(10):e00078. doi: 10.14309/ctg.0000000000000078. PMID: 31584459Free PMC Article
Small intestinal bacterial overgrowth syndrome.
Bures J, Cyrany J, Kohoutova D, Förstl M, Rejchrt S, Kvetina J, Vorisek V, Kopacova M
World J Gastroenterol 2010 Jun 28;16(24):2978-90. doi: 10.3748/wjg.v16.i24.2978. PMID: 20572300Free PMC Article

Clinical prediction guides

Alternative Treatment Approaches to Small Intestinal Bacterial Overgrowth: A Systematic Review.
Nickles MA, Hasan A, Shakhbazova A, Wright S, Chambers CJ, Sivamani RK
J Altern Complement Med 2021 Feb;27(2):108-119. Epub 2020 Oct 19 doi: 10.1089/acm.2020.0275. PMID: 33074705
High Prevalence of Small Intestinal Bacterial Overgrowth among Functional Dyspepsia Patients.
Tziatzios G, Gkolfakis P, Papanikolaou IS, Mathur R, Pimentel M, Damoraki G, Giamarellos-Bourboulis EJ, Dimitriadis G, Triantafyllou K
Dig Dis 2021;39(4):382-390. Epub 2020 Oct 2 doi: 10.1159/000511944. PMID: 33011725
Small Intestinal Bacterial Overgrowth: Clinical Features and Therapeutic Management.
Rao SSC, Bhagatwala J
Clin Transl Gastroenterol 2019 Oct;10(10):e00078. doi: 10.14309/ctg.0000000000000078. PMID: 31584459Free PMC Article
Characteristics of intestinal bacteria with fatty liver diseases and cirrhosis.
Guohong-Liu, Qingxi-Zhao, Hongyun-Wei
Ann Hepatol 2019 Nov-Dec;18(6):796-803. Epub 2019 Sep 13 doi: 10.1016/j.aohep.2019.06.020. PMID: 31558417
Diagnosis of small intestinal bacterial overgrowth in the clinical practice.
Gabrielli M, D'Angelo G, Di Rienzo T, Scarpellini E, Ojetti V
Eur Rev Med Pharmacol Sci 2013;17 Suppl 2:30-5. PMID: 24443065

Recent systematic reviews

Post-discharge follow-up of congenital duodenal obstruction patients: a systematic review.
Lum Min SA, Imam M, Zrinyi A, Shawyer AC, Keijzer R
Pediatr Surg Int 2023 Jul 25;39(1):239. doi: 10.1007/s00383-023-05515-w. PMID: 37490166
Show Me What You Have Inside-The Complex Interplay between SIBO and Multiple Medical Conditions-A Systematic Review.
Sroka N, Rydzewska-Rosołowska A, Kakareko K, Rosołowski M, Głowińska I, Hryszko T
Nutrients 2022 Dec 24;15(1) doi: 10.3390/nu15010090. PMID: 36615748Free PMC Article
Alternative Treatment Approaches to Small Intestinal Bacterial Overgrowth: A Systematic Review.
Nickles MA, Hasan A, Shakhbazova A, Wright S, Chambers CJ, Sivamani RK
J Altern Complement Med 2021 Feb;27(2):108-119. Epub 2020 Oct 19 doi: 10.1089/acm.2020.0275. PMID: 33074705
Small Intestinal Bacterial Overgrowth in Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis of Case-Control Studies.
Shah A, Talley NJ, Jones M, Kendall BJ, Koloski N, Walker MM, Morrison M, Holtmann GJ
Am J Gastroenterol 2020 Feb;115(2):190-201. doi: 10.14309/ajg.0000000000000504. PMID: 31913194
Obesity and Risk of Small Intestine Bacterial Overgrowth: A Systematic Review and Meta-Analysis.
Wijarnpreecha K, Werlang ME, Watthanasuntorn K, Panjawatanan P, Cheungpasitporn W, Gomez V, Lukens FJ, Ungprasert P
Dig Dis Sci 2020 May;65(5):1414-1422. Epub 2019 Oct 11 doi: 10.1007/s10620-019-05887-x. PMID: 31605277

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