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Prevalence of small intestinal bacterial overgrowth in intestinal failure syndrome: A systematic review and

Ayesha Shah1,2,3, Thomas Fairlie1,2,3, Mark Morrison1,2,4

  • 1Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.

Journal of Gastroenterology and Hepatology
|June 27, 2024
PubMed
Abstract

Insights

Small intestinal bacterial overgrowth (SIBO) affects over half of patients with intestinal failure (IF). Parenteral nutrition (PN) significantly increases SIBO risk in IF patients.

Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Clinical Research

Background:

  • Intestinal failure (IF) is characterized by abnormal intestinal anatomy, secretion, and motility, leading to impaired homeostasis.
  • Small intestinal bacterial overgrowth (SIBO) is a common complication in patients with IF.

Approach:

  • A systematic review and meta-analysis was conducted to determine SIBO prevalence in IF.
  • MEDLINE and Embase databases were searched from inception to December 2023.
  • Random effects models were used to calculate prevalence rates and identify risk factors.

Key Points:

  • The prevalence of SIBO in IF was found to be 57.5%.
  • SIBO was sixfold higher in IF patients receiving parenteral nutrition (PN) compared to those not on PN.
  • Prevalence was numerically higher in IF patients using PPI/acid-suppressing agents (72.0%) versus those not using them (47.6%).

Conclusions:

  • Patients with IF have an increased risk of SIBO.
  • PN and potentially PPI/acid-suppressing agents are identified as risk factors for SIBO in IF.
  • The evidence quality is low due to heterogeneity and lack of case-control studies.
Keywords:
SIBObacterial overgrowthbreath testsintestinal failureprevalenceshort gut syndrome

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