SMALL-BOWEL BACTERIAL OVERGROWTH AS A CAUSE OF CHRONIC DIARRHEA AFTERLIVER-TRANSPLANTATION IN CHILDREN

Children who have undergone liver transplantation may develop chronic diarrhea for a number of reasons. Three children who underwent liver t ransplantation for liver failure, all of whom had had previous biliary and intestinal surgeries and whose postoperative course was marked by signs and symptoms of intestinal malabsorption including chronic diar rhea, are described. Duodenal aspirates showed a panoply of bacterial species, and duodenal histology featured villus atrophy in two: one as sociated with luminal gram-positive cocci and another with acute and c hronic duodenitis, Oral antibiotics cleared the symptoms. Small bowel bacterial overgrowth may need to be considered in children with chroni c diarrhea after liver transplantation, especially when previous intes tinal surgery has taken place. Long-term antibiotic therapy may be req uired to effectively eradicate the offending organisms to suppress sym ptoms. Copyright (C) 1998 by the American Association for the Study of Liver Diseases.