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Small intestinal bacterial overgrowth in patients with cirrhosis: prevalence and relation with spontaneous bacterial

T M Bauer1, B Steinbrückner, F E Brinkmann

  • 1Department of Medicine II and Institute of Medical Microbiology and Hygiene, University Hospital, Freiburg, Germany.

The American Journal of Gastroenterology
|November 6, 2001
PubMed
Abstract

Insights

Small intestinal bacterial overgrowth is common in cirrhosis patients and linked to acid-suppressive therapy. However, it does not appear to cause spontaneous bacterial peritonitis in these individuals.

Area of Science:

  • Gastroenterology
  • Hepatology
  • Microbiology

Background:

  • Small intestinal bacterial overgrowth (SIBO) prevalence and diagnostic criteria in cirrhosis patients remain unclear.
  • The relationship between SIBO and spontaneous bacterial peritonitis (SBP) in cirrhosis requires further investigation.

Purpose of the Study:

  • To investigate the association between SIBO and SBP in patients with cirrhosis.
  • To compare different microbiological criteria for diagnosing SIBO.
  • To evaluate clinical characteristics and outcomes related to SIBO and SBP.

Main Methods:

  • Quantitative cultivation of jejunal secretions from 70 cirrhosis patients.
  • Classification of SIBO based on various definitions.
  • 1-year follow-up monitoring of SBP incidence and clinical characteristics.

Main Results:

  • SIBO was identified in 61% of patients, associated with acid-suppressive therapy and hypochlorhydria.
  • SBP occurred in 6 patients, correlating with ascitic fluid protein and serum bilirubin.
  • No significant association was found between SIBO and SBP (p = 0.39).

Conclusions:

  • SIBO in cirrhosis patients is linked to acid-suppressive therapy and hypochlorhydria.
  • SIBO is not significantly associated with the occurrence of SBP in this cohort.
  • The role of acid-suppressive therapy in SBP pathogenesis warrants further research.

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