Question

True about blind loop syndrome, all EXCEPT

• A. Syndrome of bacterial overgrowth
• B. Steatorrhea, megaloblastic anemia and deficiency of fat soluble vitamins
• C. Surgery is not indicated
• D. 14C-xylose or 14C-cholylglycine breath tests are indirect tests for bacterial overgrowth

Hint:

If an anatomical blind loop causes the stasis, what definitive treatment may still be required?

Answer 1

The Correct Option is C

Step 1: Blind loop syndrome is a syndrome of small-bowel bacterial overgrowth, usually caused by stasis in a surgically created or anatomically blind segment of bowel.

Step 2: The overgrowing bacteria deconjugate bile salts and consume vitamin B12, producing steatorrhoea, megaloblastic (vitamin B12 deficiency) anaemia, weight loss and deficiency of fat-soluble vitamins. So options a and b are true.

Step 3: Diagnosis uses indirect breath tests such as the 14C-xylose or 14C-cholylglycine (glycocholate) breath test, which detect bacterial metabolism. So option d is true.

Step 4: Treatment is broad-spectrum antibiotics and nutritional support, but when an anatomical cause (blind loop, stricture, fistula) is responsible, corrective surgery IS indicated. Therefore the false statement is that surgery is not indicated, making option c the exception.