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

Ayesha Shah1,2,3, Erin Shanahan1,3, Graeme A Macdonald1,2,3

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

Seminars in Liver Disease
|December 23, 2017
PubMed

Insights

Small intestinal bacterial overgrowth (SIBO) is significantly more prevalent in patients with chronic liver disease (CLD). This association suggests SIBO may contribute to CLD progression, not just result from advanced disease.

Area of Science:

  • Gastroenterology
  • Hepatology
  • Microbiology

Background:

  • Small intestinal bacterial overgrowth (SIBO) is a condition characterized by excessive bacteria in the small intestine.
  • Chronic liver disease (CLD) encompasses a range of conditions affecting liver function over time.
  • The relationship between SIBO and CLD requires further elucidation.

Purpose of the Study:

  • To conduct a meta-analysis evaluating the prevalence of SIBO in patients with CLD compared to controls.
  • To investigate whether SIBO is associated with the severity of chronic liver disease.

Main Methods:

  • A systematic literature search was performed using keywords related to SIBO and CLD.
  • Nineteen case-control studies were included in the meta-analysis.
  • Prevalence data were analyzed using breath tests and culture techniques.

Main Results:

  • SIBO prevalence was significantly higher in CLD patients (35.80% by breath test, 68.31% by culture) compared to controls (8.0% and 7.94%, respectively).
  • No significant difference in SIBO prevalence was observed between cirrhotic and non-cirrhotic CLD patients.
  • The findings indicate a strong association between SIBO and CLD, irrespective of disease advancement.

Conclusions:

  • SIBO is significantly more frequent in patients with chronic liver disease.
  • The presence of SIBO in CLD patients suggests it may play a role in disease progression rather than being solely a consequence of advanced liver disease.
  • Further research is warranted to explore the causative role of SIBO in CLD pathogenesis.

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