Bacterial overgrowth

The small intestine normally supports a large number of bacterial flora. These are normally kept in check by intestinal peristalsis, the acidity of chyme leaving the stomach, and the secretion of immunoglobulins into the intestinal lumen by mucosal cells. If one or more of these factors is reduced, bacterial overgrowth may result in malabsorption. Diagnosis is by aspiration of the contents of the jejunum, which will reveal increased numbers of both aerobic and anaerobic organisms. If bacterial overgrowth is present, enzymes in the bacteria can inactivate bile acids, leading to fat malabsorption. The gut flora may catabolise ingested proteins, metabolise sugars and bind vitamin B12. Bacterial overgrowth is treated with antibiotics.

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