The underlying disturbance common to all cases of the blind loop syndrome is bacterial overgrowth in the proximal small bowel. Stasis of intestinal contents and direct contamination via a fistula from the lower bowel predispose to bacterial overgrowth. Clinical components of the syndrome are diarrhea, steatorrhea, macrocytic anemia, and malnutrition. Awareness of predisposing conditions and proper interpretation of tests for steatorrhea aid diagnosis. A surgical approach to treatment should be considered in the presence of afferent loop stasis, jejunal diverticula, gastrojejunocolic fistula, or intestinal stricture. Medical therapy includes parenteral administration of vitamin B12, oral use of antibiotics, dietary substitution of fats containing medium chain triglycerides for those containing long chain triglycerides, and use of antidiarrheal agents.
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