Prevalence and Factors Associated With Small Intestinal Bacterial Overgrowth in Patients With Crohn’s Disease: A Retrospective Study at a Referral Center

Bertges, Érika Ruback; Chebli, Liliana Andrade

doi:10.1590/s0004-2803.202000000-64

Cited by 9 publications

(10 citation statements)

References 30 publications

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“…Alternatively, the breath test, a widely used method for diagnosing SIBO, has the advantages of being simple, non-invasive and easily acceptable. Recent studies have shown that SIBO is closely associated with various diseases, including Crohn's disease [3], irritable bowel syndrome [4], functional AGING dyspepsia [5], hepatic encephalopathy [6], and nonalcoholic fatty liver disease [7].…”

Section: Introductionmentioning

confidence: 99%

The prevalence of small intestinal bacterial overgrowth in diabetes mellitus: a systematic review and meta-analysis

Feng¹,

2022

Aging

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Objective: We conducted this systematic review and meta-analysis to estimate the prevalence of SIBO in diabetic patients and to determine the association between SIBO and diabetes. Methods: A comprehensive literature search of the PubMed, Cochrane Library and EMBASE databases from inception to June 2021 was conducted for studies correlating SIBO with diabetes. Studies were screened, and relevant data were extracted and analysed. The pooled prevalence of SIBO among diabetic patients and the odds ratio of SIBO among diabetic patients compared with controls were calculated. Results: Fourteen studies including 1417 diabetic patients and 649 controls met the inclusion criteria. The pooled prevalence of SIBO in diabetes was 29% (95% CI 20-39%). The odds ratio of SIBO in diabetic patients was 2.91 (95% CI 0.82-10.32, p=0.1) compared with controls. Subgroup analyses showed that the prevalence of SIBO in diabetes was higher in studies using jejunal aspirate culture for diagnosis (39%, 95% CI 12-66%) than in those using the lactulose breath test (31%, 95% CI 18-43%) or glucose breath test (29%, 95% CI 14-43%). The prevalence of SIBO in diabetes was higher in studies conducted in Western countries (35%, 95% CI 21-49%) than in those conducted in Eastern countries (24%, 95% CI 14-34%), and the prevalence of SIBO in type 1 diabetes (25%, 95% CI 14%-36%) was not significantly different from that in type 2 diabetes (30%, 95% CI 13%-47%). Conclusions: Twenty-nine percent of diabetic patients tested positive for SIBO, and the risk of SIBO in diabetic patients was 2.91 times higher than that in patients without diabetes. Diabetes could be a predisposing factor

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Section: Introductionmentioning

confidence: 99%

The prevalence of small intestinal bacterial overgrowth in diabetes mellitus: a systematic review and meta-analysis

Feng¹,

2022

Aging

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“…We also assessed the association between SIBO and the clinical data of people with CD. Numerous investigations have observed that surgical procedures, as well as strictures or fistulae, are risk factors for the presence of SIBO in people with CD (10,16,17,20,22). We found that patients who were SIBO-positive showed higher rates of stricturing phenotypes and intestinal resection than SIBO-negative patients, although the difference was not statistically significant.…”

Section: Discussionmentioning

confidence: 48%

“…Alterations in the GI microbiome occur in patients with CD. Numerous studies have suggested a link between SIBO and CD (10,(16)(17)(18)(19)(20)(21)(22)(23), but the significance of SIBO in diagnosing quiescent CD has not been extensively researched. In this study, we explored whether SIBO is associated with subsequent clinical relapse of CD.…”

Section: Discussionmentioning

confidence: 99%

Small intestinal bacterial overgrowth is associated with clinical relapse in patients with quiescent Crohn’s disease: a retrospective cohort study

Wei¹,

Feng²,

Chen³

et al. 2022

Ann Transl Med

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Background: Crohn's disease (CD) is an irreversible inflammatory disorder, characterized by alternating periods of relapse and remission. It is particularly important to predict clinical relapses in patients with CD because patients in remission could relapse frequently in a randomized way. Small intestinal bacterial overgrowth (SIBO) is a symptom of gut microbial dysbiosis and is commonly observed in patients with CD, which may affect disease course. The present research was carried out to establish whether SIBO is linked to the subsequent clinical relapse of CD.Methods: This retrospective observational cohort research included consecutive patients (≥18 years) with quiescent CD who underwent lactulose hydrogen-methane breath test to diagnose SIBO managed at Jinling Hospital in China from January 2016 to June 2020. We assessed demographic data, laboratory parameters, SIBO and clinical characteristics including disease location and behavior, surgical history and current and previous medication at baseline and analyzed these data to identify factors associated with clinical relapse.Patients were followed up for 18 months and assessed for the Crohn's Disease Activity Index (CDAI) scores, treatment escalation, and disease progression to determine the primary endpoint of clinical relapse.Results: Of the 73 enrolled patients, 34 (46.6%) were positive for SIBO. Twenty-seven (37.0%) patients experienced clinical relapse within 18 months (median time of relapse: 13.9 months). SIBO in the relapse group was considerably elevated compared to the non-relapse group (63.0% vs. 37.0%, P=0.032). The multivariate Cox regression analysis showed that SIBO [hazard ratio (HR) 2.79, P=0.017] and penetrating disease behavior (HR 3.66, P=0.040) were the sole individual risk elements for relapse in patients with quiescent CD.Conclusions: This study indicated that SIBO was highly prevalent in patients with CD, and was independently linked to clinical relapse in quiescent patients. Detecting SIBO may be a valuable option for the prognostic assessment of patients in clinical remission.

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“…Клинические проявления СИБР могут варьировать от отсутствия симптомов до тяжелых последствий мальабсорбции и включать диарею, метеоризм, боли в животе, дефицит витаминов, включая B 12 , железодефицитную анемии, гипоальбуминемию, потерю массы тела [1,4,5,9,[12][13][14][15][16].…”

Section: Introductionunclassified

Excessive bacterial growth syndrome in small intestine burdens the clinical picture of inflammatory bowel diseases

Kulygin,

Osipenko

2023

jour

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Research objective: to study the frequency of small intestinal bacterial overgrowth (SIBO) and factors associated with it in patients with inflammatory bowel diseases (IBD). Materials and methods of the study: 152 patients with IBD (Crohn’s disease and ulcerative colitis) a hydrogen breathing test (HBT) with lactulose, performed by the “Gastro+” monitor using lactulose. In all patients, the characteristics of the course of IBD were evaluated, including 60 parameters: the time of diagnosis of IBD, the existing symptoms assessed by a visually analog scale (VAS), extra-intestinal manifestations, current and previous treatment, severity of attack, extent of the lesion in UC, phenotypic variant in CD, the level of endoscopic activity, the presence or absence of surgical interventions, indicators of laboratory and instrumental methods of examination, etc. Results. The frequency of positive hydrogen breath test was 48%, in patients with CD - 50.7% (n=36), in patients with UC - 45.7% (n=37) (p= 0.626). The presence of SIBO in general in IBD patients was associated with the level of clinical and endoscopic activity and the form of the disease, the severity of the attack; as well as in UC patients - the extent of the colon lesion, in CD patients - the presence of penenting and stenosing phenotypes. Patients with IBD with the presence of SIBR complain of a greater number of defecations, a lower body mass index, the presence of a decrease in body weight within 1 month before the examination and more frequent complaints of bloating, flatulence, tearfulness and weakness. Thus, a hydrogen breath test can be used for differential diagnosis of exacerbation of IBD from clinical manifestations caused by SIBO.

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Prevalence and Factors Associated With Small Intestinal Bacterial Overgrowth in Patients With Crohn’s Disease: A Retrospective Study at a Referral Center

Cited by 9 publications

References 30 publications

The prevalence of small intestinal bacterial overgrowth in diabetes mellitus: a systematic review and meta-analysis

The prevalence of small intestinal bacterial overgrowth in diabetes mellitus: a systematic review and meta-analysis

Small intestinal bacterial overgrowth is associated with clinical relapse in patients with quiescent Crohn’s disease: a retrospective cohort study

Excessive bacterial growth syndrome in small intestine burdens the clinical picture of inflammatory bowel diseases

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