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Small-intestinal bacterial overgrowth in cirrhosis is related to the severity of liver disease

C Pande1, A Kumar, S K Sarin

  • 1Department of Gastroenterology, GB Pant Hospital, New Delhi, India.

Alimentary Pharmacology & Therapeutics
|March 24, 2009
PubMed
Abstract

Insights

Small-intestinal bacterial overgrowth (SIBO) affects nearly half of cirrhosis patients, increasing with disease severity. Ascites and elevated bilirubin levels reliably indicate SIBO presence in these individuals.

Area of Science:

  • Gastroenterology
  • Hepatology
  • Microbiology

Background:

  • Small-intestinal bacterial overgrowth (SIBO) is a known complication in cirrhosis patients.
  • SIBO can predispose individuals to further health issues.

Purpose of the Study:

  • To determine the frequency of SIBO in patients with cirrhosis.
  • To correlate SIBO prevalence with the severity of liver cirrhosis.

Main Methods:

  • SIBO was diagnosed using the glucose-hydrogen breath test (GHBT).
  • A positive GHBT was defined by specific hydrogen levels post-glucose administration.
  • SIBO prevalence was compared between cirrhotics and healthy controls and correlated with cirrhosis severity.

Main Results:

  • 49% of 53 cirrhosis patients had SIBO, compared to 8% in controls (P=0.010).
  • SIBO prevalence increased with cirrhosis severity (Child-Pugh A: 20%, B: 52%, C: 73%; P=0.013).
  • Serum bilirubin (> or = 2 mg/dL) and ascites were independent predictors of SIBO.

Conclusions:

  • SIBO is highly prevalent in cirrhosis, affecting approximately half of patients.
  • The frequency of SIBO escalates with increasing cirrhosis severity.
  • Ascites and elevated serum bilirubin are reliable indicators for predicting SIBO in cirrhosis.

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