Small bowel bacterial overgrowth syndrome
may be an underappreciated cause of malnutrition, especially in the elderly.
We previously have shown that fructose malabsorption is a promoting factor for small intestinal bacterial overgrowth syndrome
and is associated with higher serum neopterin concentrations (19), an indicator of immune activation.
Bacterial populations contaminating the upper gut in patients with small intestinal bacterial overgrowth syndrome
The possibility of bacterial overgrowth was considered, and routine qualitative urinary organic acid analysis (gas chromatography-mass spectrometry) (4) revealed increased excretion of lactate, 3-hydroxypropionate, phenyllactate, and 4-hydroxyphenylacetate, a pattern characteristic of bacterial overgrowth syndrome
Organic acids in urine revealed a markedly elevated 4-hydroxyphenylacetic acid level; a finding that has been associated with small bowel disease and bacterial overgrowth syndromes