THE ROLE OF THE UPPER GASTROINTESTINAL FLORA IN THE MALABSORPTION SYNDROME.

Bacterial contamination of the upper gastrointestinal tract by colonic flora appears important in the production of some forms of secondary steatorrhea. Gastric contents have been studied in patients with normal intestinal absorption and with malabsorption syndrome. In secondary steatorrhea there is a significantly increased incidence of gastric contamination by colon organisms, and this is usually associated with absence of free hydrochloric acid. It seems probable that such contamination interferes with intestinal digestion and absorption. The benefit resulting from the oral administration of broad-spectrum antibiotics to a group of patients with secondary steatorrhea supports this concept.