Contaminated small bowel syndrome as cause of malnutrition in the elderly

Contaminated small bowel syndrome may be defined as a syndrome of chronic malabsorption due to intraluminal bacterial overgrowth. As in elderly protective mechanisms are impaired, we propose contaminated small bowel syndrome is a major cause of malnutrition in old age. Sampling of jejunal fluid by a tube capable of maintaining a strict anerobic environment has been shown to provide a reliable measurement of jejunal bacterial colonization. Jejunal juice has been obtained by this method from 9 elderly subjects (age 65-78) and bacteriologic analysis of jejunal samples revealed a bacterial concentration > 106/ml. Furthermore, although all patients had predisposing situations to develop contaminated small bowel syndrome, only 4 of them had clinical evidence of malabsorption.