Bacterial Overgrowth and Enteric Infections

Small intestinal overgrowth (SIBO) is common in intestinal failure. It occurs when there are alterations in intestinal anatomy, gastrointestinal motility, or a lack of gastric acid secretion. Its presence may contribute to symptoms, mucosal injury, and malnutrition. Unfortunately, the diagnosis of bacterial overgrowth remains a challenge. In the absence of well conducted clinical trials, therapy remains mainly empirical and consists of the eradication of bacterial overgrowth with antibiotics, nutritional support and, when possible, the correction of underlying predisposing conditions. Chronic enteric infections are rare and HIV now rarely causes intestinal failure though patients with common variable immunodeficiency (CVID) may have chronic infections (e.g. with norovirus).