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Bacterial Overgrowth Syndrome Follow-up

  • Author: Saqib Zaheer Syed, MBBS; Chief Editor: Michael Stuart Bronze, MD  more...
 
Updated: Mar 17, 2016
 

Further Outpatient Care

No specific guidelines for bacterial overgrowth syndrome exist; however, close interval follow-up is recommended to ensure that therapy is improving symptoms. It is also not clearly defined whether serial testing for increased bacteria burden is warranted.

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Further Inpatient Care

Admission criteria for bacterial overgrowth syndrome (BOS) should be based on severity of clinical manifestations at presentation, especially in high-risk individuals.

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Complications

Complications of bacterial overgrowth syndrome are possible in patients with prolonged and untreated symptoms, potentially leading to increased morbidity and mortality in higher-risk patients (eg, the very young and elderly).

Malabsorption of iron, vitamin B-12, and folate can lead to anemia

Persistent diarrhea can lead to volume loss and electrolyte disturbances.

Decreased fat absorption can lead to further diarrhea.

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Prognosis

If bacterial overgrowth syndrome is the result of an underlying medical problem that cannot be controlled, relapse will occur, with symptom-free periods.

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Patient Education

Patients with chronic diarrhea should be educated on avoidance of food products that may exacerbate symptoms. Patients with bacterial overgrowth syndrome should document which foods cause their diarrhea, as this can vary among patients. Some examples of such foods are those high in carbohydrates such as fruits and fruit juices, spicy food, milk-containing products, fried food, and high-fat foods.

Patients should also be educated on early detection of symptoms such as diarrhea to avoid malabsorption.

In high-risk patients (eg, neonates and elderly patients), early recognition is challenging. Education should be extended to the primary care givers in this situation.

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Contributor Information and Disclosures
Author

Saqib Zaheer Syed, MBBS Resident Physician, Department of Internal Medicine, University of Oklahoma Health Science Center

Disclosure: Nothing to disclose.

Coauthor(s)

Michael Stuart Bronze, MD David Ross Boyd Professor and Chairman, Department of Medicine, Stewart G Wolf Endowed Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center; Master of the American College of Physicians; Fellow, Infectious Diseases Society of America

Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, Oklahoma State Medical Association, Southern Society for Clinical Investigation, Association of Professors of Medicine, American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Joseph F John, Jr, MD, FACP, FIDSA, FSHEA Clinical Professor of Medicine, Molecular Genetics and Microbiology, Medical University of South Carolina College of Medicine; Associate Chief of Staff for Education, Ralph H Johnson Veterans Affairs Medical Center

Joseph F John, Jr, MD, FACP, FIDSA, FSHEA is a member of the following medical societies: Charleston County Medical Association, Infectious Diseases Society of America, South Carolina Infectious Diseases Society

Disclosure: Nothing to disclose.

Chief Editor

Michael Stuart Bronze, MD David Ross Boyd Professor and Chairman, Department of Medicine, Stewart G Wolf Endowed Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center; Master of the American College of Physicians; Fellow, Infectious Diseases Society of America

Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, Oklahoma State Medical Association, Southern Society for Clinical Investigation, Association of Professors of Medicine, American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Additional Contributors

Mark R Wallace, MD, FACP, FIDSA Clinical Professor of Medicine, Florida State University College of Medicine; Clinical Professor of Medicine, University of Central Florida College of Medicine

Mark R Wallace, MD, FACP, FIDSA is a member of the following medical societies: American College of Physicians, American Medical Association, American Society for Microbiology, Infectious Diseases Society of America, International AIDS Society, Florida Infectious Diseases Society

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors Pedro A Manibusan Jr, DO; Joshua S Hawley, MD; Richard E Frye, MD, PhD; M Akram Tamer, MD; and Burke A Cunha, MD, to the development and writing of this article.

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