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*

*Corresponding author for this work

    Research output: Contribution to journalReview articlepeer-review

    17 Citations (Scopus)

    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.

    Original languageEnglish
    Pages (from-to)388-400
    Number of pages13
    JournalSeminars in Liver Disease
    Volume37
    Issue number4
    DOIs
    Publication statusPublished - 2017

    Keywords

    • cirrhosis
    • bacterial overgrowth
    • prevalence
    • breath tests
    • NAFLD

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