Systematic Review and Meta-Analysis: Prevalence of Small Intestinal Bacterial Overgrowth in Chronic Liver Disease

Ayesha Shah; Erin Shanahan; Graeme A. Macdonald; Linda Fletcher; Pegah Ghasemi; Mark Morrison; Mike Jones; Gerald Holtmann

doi:10.1055/s-0037-1608832

Seminars in Liver Disease, Table of Contents

Semin Liver Dis 2017; 37(04): 388-400
DOI: 10.1055/s-0037-1608832

Review Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Systematic Review and Meta-Analysis: Prevalence of Small Intestinal Bacterial Overgrowth in Chronic Liver Disease

Ayesha Shah

¹Faculty of Medicine, Princess Alexandra Hospital, The University of Queensland, Brisbane, Queensland, Australia

²Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia

³Translational Research Institute, Princess Alexandra Hospital, Brisbane, Queensland, Australia

,

Erin Shanahan

¹Faculty of Medicine, Princess Alexandra Hospital, The University of Queensland, Brisbane, Queensland, Australia

³Translational Research Institute, Princess Alexandra Hospital, Brisbane, Queensland, Australia

,

Graeme A. Macdonald

¹Faculty of Medicine, Princess Alexandra Hospital, The University of Queensland, Brisbane, Queensland, Australia

²Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia

³Translational Research Institute, Princess Alexandra Hospital, Brisbane, Queensland, Australia

,

Linda Fletcher

¹Faculty of Medicine, Princess Alexandra Hospital, The University of Queensland, Brisbane, Queensland, Australia

²Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia

,

Pegah Ghasemi

¹Faculty of Medicine, Princess Alexandra Hospital, The University of Queensland, Brisbane, Queensland, Australia

²Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia

,

Mark Morrison

¹Faculty of Medicine, Princess Alexandra Hospital, The University of Queensland, Brisbane, Queensland, Australia

⁴Diamantina Institute, Microbial Biology and Metagenomics, University of Queensland, Queensland, Australia

,

Mike Jones

⁵Department of Psychology, Macquarie University, Sydney, New South Wales, Australia

,

Gerald Holtmann

¹Faculty of Medicine, Princess Alexandra Hospital, The University of Queensland, Brisbane, Queensland, Australia

²Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia

³Translational Research Institute, Princess Alexandra Hospital, Brisbane, Queensland, Australia

› Author Affiliations

Abstract

The authors conducted a meta-analysis of the prevalence of small intestinal bacterial overgrowth (SIBO) in patients with chronic liver disease (CLD) and controls. Using the search terms “small intestinal bacterial overgrowth (SIBO)” and “chronic liver disease (CLD)” or “cirrhosis,” 19 case-control studies were identified. Utilizing breath tests, the prevalence of SIBO in CLD was 35.80% (95% CI, 32.60–39.10) compared with 8.0% (95% CI, 5.70–11.00) in controls. Using culture techniques, the prevalence was 68.31% (95% CI, 59.62–76.00) in CLD patients as compared with 7.94% (95% CI, 3.44–12.73) in controls. No difference between cirrhotic and noncirrhotic patients was found. SIBO is significantly more frequent in CLD patients as compared with controls. The association of SIBO and CLD was not confined to patients with advanced CLD, suggesting that SIBO is not a consequence of advanced liver disease but may play a role in the progression of CLD.

Keywords

cirrhosis - bacterial overgrowth - prevalence - breath tests - NAFLD

Full Text

References

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