The doctor’s expression was grim as he pushed the tube hydrating me out of the way and palpated my abdomen. After he finished, he said he was going to call a surgeon to come and have a look. Since I was a patient who had already had five surgeries for Crohn’s disease, he was worried that the cause of my hospital admission was blind loop syndrome.
Blind loop syndrome is a condition that develops when a section of the small intestine is bypassed. Food traveling through the digestive tract either stops moving or moves more slowly than normal through the intestine, according to MedlinePlus.
The affected bowel loop ends up cut off from digestive juices and the normal flow of food. The resulting backup of food causes bacterial overgrowth in the gut and makes it difficult to properly absorb nutrients.
This condition is also called stagnant loop syndrome and stasis syndrome.
Patients with the inflammatory bowel diseases ulcerative colitis and Crohn’s disease have an elevated risk for developing blind loop syndrome. So do those with diseases like diabetes and scleroderma. These disorders can cause peristalsis, the contractions that propel food through the digestive tract, to slow down.
As food stagnates in the blind loop of intestine, it serves as the perfect place for bacteria to thrive, the Mayo Clinic reports. The unwanted bacteria that develop in a blind loop can interfere with the patient’s nutritional absorption and might also release toxins.
Additional causes of this disorder are complications of abdominal surgery, abnormalities in the structure of the small bowel, and the bacterial overgrowth associated with illnesses like Crohn’s disease, scleroderma, and diabetes. Patients with diverticulosis in the small intestine and those with a fistula – an abnormal path – between two bowel segments are also at elevated risk.
In addition to having several risk factors for blind loop syndrome, I had a number of its symptoms. Patients most commonly suffer from nausea, diarrhea, abdominal pain, and stools that are fatty, frothy, and foul-smelling.
Some also experience a loss of appetite, bloating, and/or a sensation of fullness after they eat. Unintentional weight loss isn’t uncommon.
Among the potential complications of blind loop syndrome are a complete intestinal obstruction, death of the intestine, an intestinal perforation, and serious malabsorption and malnutrition issues. Two others are the development of a vitamin B-12 deficiency and osteoporosis.
Diagnosis and Treatment
Following a physical exam, the standard tests for blind loop syndrome are an abdominal X-ray and an abdominal CT scan. Fortunately, a CT scan on my second day in the hospital showed that the partial small bowel obstruction an X-ray said I had at admission had cleared. It also revealed that while I had several signs of this disorder, it wasn’t the culprit.
Laboratory tests can also confirm bacterial overgrowth, substandard fat absorption, or other problems that might cause the symptoms associated with this disorder. Some patients undergo a barium X-ray of the small bowel.
Hydrogen breath tests also reveal bacterial overgrowth. The most sensitive test for overgrowth is known as an aspiration and fluid culture, which involves collecting a sample of intestinal fluid by the use of endoscopy.
Unfortunately, doctors aren’t able to resolve all cases of blind loop syndrome. When this is the case, efforts switch to quelling bacterial overgrowth and remedying nutritional deficiencies.
For most patients, however, relief is possible after the underlying problem has been solved. This might mean resolving an intestinal stricture or fistula. It can also mean surgery to repair a blind loop that develops after an earlier operation.
The most common way to treat bacterial overgrowth is a course of either short- or long-term antibiotics, depending on the patient’s needs. Balancing bacteria in the small intestine can be difficult, as antibiotics themselves sometimes upset it.
Most patients also need help to reverse nutritional deficiencies. The most common treatments include the using nutritional supplements, adopting a lactose-free diet, and prescribing medium-chain triglycerides for those with severe cases. When medical remedies fail, surgery for blind loop syndrome is required. Fortunately, the typical outcome is positive.