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Small bowel bacterial overgrowth as a cause of chronic diarrhea after liver transplantation in children
Author(s) -
Mack, David R.,
Dhawan Anil,
Kaufman Stuart S.,
Langnas Alan N.,
Seemayer Thomas A.
Publication year - 1998
Publication title -
liver transplantation and surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1074-3022
DOI - 10.1002/lt.500040202
Subject(s) - medicine , malabsorption , diarrhea , gastroenterology , chronic diarrhea , transplantation , liver transplantation , villous atrophy , antibiotics , duodenitis , gastritis , helicobacter pylori , disease , biology , coeliac disease , microbiology and biotechnology
Children who have undergone liver transplantation may develop chronic diarrhea for a number of reasons. Three children who underwent liver transplantation 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 diarrhea, are described. Duodenal aspirates showed a panoply of bacterial species, and duodenal histology featured villus atrophy in two: one associated with luminal gram‐positive cocci and another with acute and chronic duodenitis. Oral antibiotics cleared the symptoms. Small bowel bacterial overgrowth may need to be considered in children with chronic diarrhea after liver transplantation, especially when previous intestinal surgery has taken place. Long‐term antibiotic therapy may be required to effectively eradicate the offending organisms to suppress symptoms.