DEMENTIA DUE TO BACTERIAL OVERGROWTH IN A PATIENT WITH BILLROTH-II ANASTOMOSIS

We report the case of a patient in the Psychiatric Department who comp lained of progressive impairment of cerebral functions consistent with dementia, diarrhea and fecal incontinence in the last few months. His medical history included a Billlroth II gastrectomy for gastric ulcer , Biochemical tests detected cobalamine deficiency, without megaloblas tic anemia, and an abnormal Shilling test that was not due to intrinsi c factor deficiency, Once other causes of cobalamine deficiency were r uled out, we considered it as a deficiency disease due to blind loop s yndrome, Treatment with parenteral vitamin B complex and long term ora l antibiotic therapy allowed the complete and permanent resolution of neurologic and digestive symptoms. We consider this case to be interes ting because it shows the existence of curable dementias and the usefu lness of taking into account bacterial overgrowth, usually underestima ted, as an entity that can produce a variety of disorders.