Tags

Type your tag names separated by a space and hit enter

Small-intestinal bacterial overgrowth in cirrhosis is related to the severity of liver disease.
Aliment Pharmacol Ther 2009; 29(12):1273-81AP

Abstract

BACKGROUND

Small-intestinal bacterial overgrowth (SIBO) is known to be present in patients with cirrhosis, predisposing to various complications.

AIM

To determine the frequency of SIBO in cirrhotics and correlate with severity of cirrhosis.

METHODS

Small-intestinal bacterial overgrowth was determined by glucose-hydrogen breath test (GHBT). A basal breath-hydrogen >20 ppm or a rise by > or = 12 ppm above baseline following glucose administration was taken as positive test. Prevalence of SIBO in cirrhotics was compared with healthy controls and correlated with severity of cirrhosis.

RESULTS

Of the 53 cirrhotics, 26 (49%) had SIBO, compared to one (8%) control (P = 0.010). The prevalence of SIBO increased with severity of cirrhosis (Child-Pugh A 20%, B 52% and C 73%; P = 0.013). On multivariate analysis, SIBO was independently associated with serum bilirubin and ascites. The best cut-off of serum bilirubin was >/=2 mg/dL [AUROC 0.77 (95% CI 0.64-0.90)] predicting SIBO with sensitivity 65%, specificity 81%, positive predictive value 77%, negative predictive value 71% and accuracy 74%. Patients having combination of ascites and serum bilirubin > or = 2 mg/dL had 82% chance, while patients having neither had only 10% chance of having SIBO.

CONCLUSIONS

Small-intestinal bacterial overgrowth was prevalent in about half of cirrhotics. Its frequency increased with increase in severity of cirrhosis. Ascites and raised serum bilirubin reliably predicted presence of SIBO.

Authors+Show Affiliations

Department of Gastroenterology, GB Pant Hospital, New Delhi, India.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19302262

Citation

Pande, C, et al. "Small-intestinal Bacterial Overgrowth in Cirrhosis Is Related to the Severity of Liver Disease." Alimentary Pharmacology & Therapeutics, vol. 29, no. 12, 2009, pp. 1273-81.
Pande C, Kumar A, Sarin SK. Small-intestinal bacterial overgrowth in cirrhosis is related to the severity of liver disease. Aliment Pharmacol Ther. 2009;29(12):1273-81.
Pande, C., Kumar, A., & Sarin, S. K. (2009). Small-intestinal bacterial overgrowth in cirrhosis is related to the severity of liver disease. Alimentary Pharmacology & Therapeutics, 29(12), pp. 1273-81. doi:10.1111/j.1365-2036.2009.03994.x.
Pande C, Kumar A, Sarin SK. Small-intestinal Bacterial Overgrowth in Cirrhosis Is Related to the Severity of Liver Disease. Aliment Pharmacol Ther. 2009 Jun 15;29(12):1273-81. PubMed PMID: 19302262.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Small-intestinal bacterial overgrowth in cirrhosis is related to the severity of liver disease. AU - Pande,C, AU - Kumar,A, AU - Sarin,S K, Y1 - 2009/03/06/ PY - 2009/3/24/entrez PY - 2009/3/24/pubmed PY - 2010/2/23/medline SP - 1273 EP - 81 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 29 IS - 12 N2 - BACKGROUND: Small-intestinal bacterial overgrowth (SIBO) is known to be present in patients with cirrhosis, predisposing to various complications. AIM: To determine the frequency of SIBO in cirrhotics and correlate with severity of cirrhosis. METHODS: Small-intestinal bacterial overgrowth was determined by glucose-hydrogen breath test (GHBT). A basal breath-hydrogen >20 ppm or a rise by > or = 12 ppm above baseline following glucose administration was taken as positive test. Prevalence of SIBO in cirrhotics was compared with healthy controls and correlated with severity of cirrhosis. RESULTS: Of the 53 cirrhotics, 26 (49%) had SIBO, compared to one (8%) control (P = 0.010). The prevalence of SIBO increased with severity of cirrhosis (Child-Pugh A 20%, B 52% and C 73%; P = 0.013). On multivariate analysis, SIBO was independently associated with serum bilirubin and ascites. The best cut-off of serum bilirubin was >/=2 mg/dL [AUROC 0.77 (95% CI 0.64-0.90)] predicting SIBO with sensitivity 65%, specificity 81%, positive predictive value 77%, negative predictive value 71% and accuracy 74%. Patients having combination of ascites and serum bilirubin > or = 2 mg/dL had 82% chance, while patients having neither had only 10% chance of having SIBO. CONCLUSIONS: Small-intestinal bacterial overgrowth was prevalent in about half of cirrhotics. Its frequency increased with increase in severity of cirrhosis. Ascites and raised serum bilirubin reliably predicted presence of SIBO. SN - 1365-2036 UR - https://www.unboundmedicine.com/medline/citation/19302262/Small_intestinal_bacterial_overgrowth_in_cirrhosis_is_related_to_the_severity_of_liver_disease_ L2 - https://doi.org/10.1111/j.1365-2036.2009.03994.x DB - PRIME DP - Unbound Medicine ER -