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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
1   Faculty of Medicine, Princess Alexandra Hospital, The University of Queensland, Brisbane, Queensland, Australia
2   Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
3   Translational Research Institute, Princess Alexandra Hospital, Brisbane, Queensland, Australia
,
Erin Shanahan
1   Faculty of Medicine, Princess Alexandra Hospital, The University of Queensland, Brisbane, Queensland, Australia
3   Translational Research Institute, Princess Alexandra Hospital, Brisbane, Queensland, Australia
,
Graeme A. Macdonald
1   Faculty of Medicine, Princess Alexandra Hospital, The University of Queensland, Brisbane, Queensland, Australia
2   Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
3   Translational Research Institute, Princess Alexandra Hospital, Brisbane, Queensland, Australia
,
Linda Fletcher
1   Faculty of Medicine, Princess Alexandra Hospital, The University of Queensland, Brisbane, Queensland, Australia
2   Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
,
Pegah Ghasemi
1   Faculty of Medicine, Princess Alexandra Hospital, The University of Queensland, Brisbane, Queensland, Australia
2   Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
,
Mark Morrison
1   Faculty of Medicine, Princess Alexandra Hospital, The University of Queensland, Brisbane, Queensland, Australia
4   Diamantina Institute, Microbial Biology and Metagenomics, University of Queensland, Queensland, Australia
,
Mike Jones
5   Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
,
Gerald Holtmann
1   Faculty of Medicine, Princess Alexandra Hospital, The University of Queensland, Brisbane, Queensland, Australia
2   Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
3   Translational Research Institute, Princess Alexandra Hospital, Brisbane, Queensland, Australia
› Author Affiliations
Further Information

Publication History

Publication Date:
22 December 2017 (online)

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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

Funding

No external funding.


Author Contributions

Ayesha Shah and Gerald Holtmann—study idea, concept and design, data extraction and interpretation of data, drafting of the manuscript.


Graeme Macdonald—interpretation of data, drafting of the manuscript, review of final manuscript.


Linda Fletcher—interpretation of data, drafting of the manuscript, review of final manuscript.


Mark Morrison—drafting of the manuscript, review of final manuscript.


Mike Jones—data analysis, review of final manuscript.


Erin Shanahan—input into drafting of the manuscript, review of final manuscript.


Pegah Ghasemi—input into drafting of the manuscript, review of final manuscript.


Supplementary Material

 

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