SMALL-BOWEL BACTERIAL OVERGROWTH - CLINIC AL COURSE, DIAGNOSTIC PROCEDURES, AND THERAPY

Evaluation of three patients, aged between three months and five years because of failure to thrive and persistent diarrhea revealed the dia gnosis of small bowel bacterial overgrowth. A combination of a typical history, endoscopy, laboratory, radiological and histological methods as well as the breath hydrogen test were used. All patients had preex isting intestinal disease: two (former premature infants) had been ope rated several times because of necrotizing enterocolitis including res ection of larger parts of small bowel. The third patient was suffering from pancolonic Hirschsprung's disease. All patients gained weight an d reported less complaints after antibiotic treatment with metronidazo le. Discussion: Small bowel bacterial overgrowth has to be considered in the differential diagnosis of failure to thrive, especially in case s with preexisting intestinal disease. The diagnosis may be substantia ted by a combination of indirect methods, Direct bacteriologic analysi s is difficult. Usually, antibiotic treatment leads to a good weight g ain after a short period of time.