Changes

Also known as: '''''Small Intestinal Bacterial Overgrowth — SIBO — ARD

| Also known as:

 

| '''Small Intestinal Bacterial Overgrowth<br>SIBO<br>ARD

==Description==

==Description==

'''Antibiotic responsive diarrhoea''' (ARD) describes a clinical syndrome which is caused by alterations in the population of enteric bacterial flora and by changes in the response of the host immune system to these bacteria.  It may occur independently of any other apparent pathological process ('''idiopathic''') but it occurs commonly with a number of intestinal diseases ('''secondary''').  The term 'antibiotic responsive diarrhoea' has replaced the previous description of '''small intestinal bacterial overgrowth''' (SIBO) due to uncertainty over the level at which enteric bacteria could be said to be present in excessive numbers and because an increased number of bacteria is not always the cause of the clinical syndrome described.  The term SIBO is now sometimes taken to mean secondary ARD.   

'''Antibiotic responsive diarrhoea''' (ARD) describes a clinical syndrome which is caused by alterations in the population of enteric bacterial flora and by changes in the response of the host immune system to these bacteria.  It may occur independently of any other apparent pathological process ('''idiopathic''') but it occurs commonly with a number of intestinal diseases ('''secondary''').  The term 'antibiotic responsive diarrhoea' has replaced the previous description of '''small intestinal bacterial overgrowth''' (SIBO) due to uncertainty over the level at which enteric bacteria could be said to be present in excessive numbers and because an increased number of bacteria is not always the cause of the clinical syndrome described.  The term SIBO is now sometimes taken to mean secondary ARD.   

**[[Lymphangiectasia]] leads to increased luminal concentrations of fat and protein.

**[[Lymphangiectasia]] leads to increased luminal concentrations of fat and protein.

**[[Villus atrophy with intact/hypertrophic crypt glands|Villous atrophy]] leads to the loss of digestive enzymes on the brush borders of enterocytes.

**[[Villus atrophy with intact/hypertrophic crypt glands|Villous atrophy]] leads to the loss of digestive enzymes on the brush borders of enterocytes.

**[[Biliary Tract - Obstruction|Extrahepatic Biliary Obstruction]] leads to an inability to digest and absorb fat because bile salts do not pass into the intestine.

**[[Biliary Tract Obstruction|Extrahepatic Biliary Obstruction]] leads to an inability to digest and absorb fat because bile salts do not pass into the intestine.

**Congenital deficiencies of brush border enzymes are very rare in animals.

**Congenital deficiencies of brush border enzymes are very rare in animals.

*Altered GI motility causing changes in the population density of enteric microflora

*Altered GI motility causing changes in the population density of enteric microflora

Primary ARD is generally diagnosed where there is a consistent signalment, history and clinical presentation and no other apparent underlying disease.  In secondary ARD, the clinical signs may be difficult to separate from those of the underlying disease, especially in animals with maldigestion/malabsorption.  The underlying disease is usually treated as a priority and the ARD may then resolve or it may require treatment with antibiotics.  

Primary ARD is generally diagnosed where there is a consistent signalment, history and clinical presentation and no other apparent underlying disease.  In secondary ARD, the clinical signs may be difficult to separate from those of the underlying disease, especially in animals with maldigestion/malabsorption.  The underlying disease is usually treated as a priority and the ARD may then resolve or it may require treatment with antibiotics.  

===Clinical Signs===

===Clinical Signs===

German Shepherd dogs with idiopathic ARD may show the following clinical signs:

German Shepherd dogs with idiopathic ARD may show the following clinical signs:

==Prognosis==

==Prognosis==

For cases of secondary ARD, the prognosis depends on the underlying cause and success of treatment.  For cases of idiopathic ARD, the prognosis is guarded and many of them are likely to relapse when treatment is stopped, which may require prolonged or life-long treatment.  Some cases, however, do resolve and only require short term treatment.

For cases of secondary ARD, the prognosis depends on the underlying cause and success of treatment.  For cases of idiopathic ARD, the prognosis is guarded and many of them are likely to relapse when treatment is stopped, which may require prolonged or life-long treatment.  Some cases, however, do resolve and only require short term treatment.

==References==

==References==

*Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) '''BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition)''' ''BSAVA''

*Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) '''BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition)''' ''BSAVA''

*Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''.

*Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''.

[[Category:Intestines,_Small_and_Large_-_Pathology]]

[[Category:Intestines,_Small_and_Large_-_Pathology]]

[[Category:To_Do_-_James]]

 

[[Category:Dog]][[Category:Cat]]

[[Category:Intestinal Diseases - Dog]][[Category:Intestinal Diseases - Cat]]

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