Blind loop syndrome
Blind loop syndrome | |
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Other names | Stagnant loop syndrome |
Specialty | Gastroenterology |
Blind loop syndrome, also known as stagnant loop syndrome,
Symptoms and signs
Most of the symptoms of blind loop syndrome are non specific but nevertheless warrant the utmost attention. These include:[citation needed]
- Loss of appetite
- Nausea
- Flatulence
- Diarrhea
- Fullness after a meal
- Fatty stools (steatorrhea)
- Unintentional weight loss
- Generalised weakness
As a result of the concomitant vitamin and mineral deficiencies that occur as a result of the malabsorption associated with blind loop syndrome patients with advanced cases should be investigated for:[citation needed]
Causes
Blind loop syndrome is a complication of surgical operations of the abdomen, as well as inflammatory bowel disease or scleroderma. Another cause is jejunoileal diverticula.[2]
Pathophysiology
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 the gastrointestinal tract and the antibacterial properties of gastric secretions, pancreatic secretions and bile.[citation needed]
It follows that a disruption of any of these factors could lead to bacterial overgrowth and indeed blind loop syndrome has been found to occur in persons with anatomical anomalies that result in stagnation. Blind loop syndrome has also been associated with
Due to the disruption of digestive processes by the overgrowth of intestinal bacteria; malabsorption of bile salts, fat and fat-soluble vitamins, protein and carbohydrates results in damage to the mucosal lining of the intestine by bacteria or via the production of toxic metabolites.
Diagnosis
A physical examination may reveal a mass or distention of the abdomen. Tests which may be useful for diagnosis include:[citation needed]
- Abdominal X-ray
- Abdominal CT scan
- Contrast enema study
Treatment
This section needs more primary sources. (August 2020) |
The treatment of blind loop syndrome follows two basic principles. When a patient presents with symptoms of blind loop syndrome, the treating physician basically has two recognized options for management:
- Test-and-treat
- Treat empirically
Test-and-treat method
Although it would seem to be the better way to go in terms of management, there has been recent criticism on the need for such testing because of reliability issues. However, it must be stated that there are options such as the glucose breath test and jejunal aspiration the explanations of which are beyond the scope of this current article.
Treating empirically
The "treat empirically" route also has its difficulties, which have all come under wide debate and study. Recommendations are varied but seem to find some common ground around the notion that treatment should be individualized to the specific circumstances under which a patient has developed blind loop syndrome since these circumstances affect the complex microbial make up of the affected bowel.
Surgical management
Surgical management is reserved for fixing anatomical causes of bowel obstruction that interfere with normal function once they are amenable to such intervention. These conditions include:[citation needed]
- Strictures
- Fistulae
- Diverticula