A patient with systemic sclerosis has recurrent bloating, steatorrhoea, weight loss and vitamin deficiencies; obstruction and pancreatic

Question

A patient with systemic sclerosis has recurrent bloating, steatorrhoea, weight loss and vitamin deficiencies; obstruction and pancreatic insufficiency are excluded. Symptoms repeatedly improve with antibiotics. What is the preferred management of symptomatic small-intestinal bacterial overgrowth?

Accepted Answer

Use rotating intermittent antibiotic courses for recurrent disease

Answer

Use total parenteral nutrition before any antimicrobial trial

Answer

Proceed directly to small-bowel resection because medical recurrence is expected

Answer

Use continuous high-dose prednisolone to reverse smooth-muscle fibrosis

Answer

Use a single seven-day antibiotic course and exclude recurrence if symptoms return

RA Work Disability — SCE Rheumatology MCQ

A patient with systemic sclerosis has recurrent bloating, steatorrhoea, weight loss and vitamin deficiencies; obstruction and pancreatic insufficiency are excluded. Symptoms repeatedly improve with antibiotics. What is the preferred management of symptomatic small-intestinal bacterial overgrowth?