Tu1066: SMALL INTESTINAL BACTERIAL OVERGROWTH IN SYSTEMIC SCLEROSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF CASE-CONTROL STUDIES

Unravelling the controversy with small intestinal bacterial overgrowth

“…Three systematic reviews and meta-analyses have confirmed increased prevalence of SIBO in patients with chronic liver disease [14–16], irrespective of the aetiology of liver disease [15] and SIBO prevalence was significantly increased in patients with decompensated cirrhosis as compared to those with compensated cirrhosis [16], (50.5% vs. 31.2%; P < 0.001). Similarly, SIBO prevalence in is increased in patients with Parkinson's disease as compared to controls (OR = 5.22, 95% CI 3.33–8.19), A recent meta-analysis [13], reported a 10-fold increased prevalence of SIBO in patients with systemic sclerosis as compared to controls, (OR = 9.6, 95% CI 5.6–16.5, P = 0.0001), with diarrhoea (OR = 5.9, 95% CI 2.9–16.0, P = 0.001) being associated with SIBO in patients with systemic sclerosis. Although the associations are well established, the role of SIBO for the pathophysiology is not always fully understood.…”

“…Similarly, SIBO prevalence in is increased in patients with Parkinson's disease as compared to controls (OR ¼ 5.22, 95% CI 3.33-8. 19), A recent meta-analysis [13], reported a 10-fold increased prevalence of SIBO in patients with systemic sclerosis as compared to controls, (OR ¼ 9.6, 95% CI 5.6-16.5, P ¼ 0.0001), with diarrhoea (OR ¼ 5.9, 95% CI 2.9-16.0, P ¼ 0.001) being associated with SIBO in patients with systemic sclerosis. Although the associations are well established, the role of SIBO for the pathophysiology is not always fully understood.…”

“…In patients with Crohn's presence of fibrostenosing disease (OR = 7.47; 95% CI 2.51–22.20) and prior bowel surgery (OR = 2.38; 95% CI 1.65–3.44), especially resection of the ileocecal valve, increased the odds of SIBO. Furthermore SIBO has been linked to several extra-intestinal disorders [11,12] including systemic sclerosis [13], chronic liver disease [14] and Parkinson's disease. Three systematic reviews and meta-analyses have confirmed increased prevalence of SIBO in patients with chronic liver disease [14–16], irrespective of the aetiology of liver disease [15] and SIBO prevalence was significantly increased in patients with decompensated cirrhosis as compared to those with compensated cirrhosis [16], (50.5% vs. 31.2%; P < 0.001).…”

“…Over the recent years, there has been cumulative evidence that small intestinal dysbiosis is linked with functional gastrointestinal conditions such as functional dyspepsia (FD) dyspepsia (FD) [5 & ], irritable bowel syndrome (IBS) [6,7]. The odds for small intestinal bacterial overgrowth (SIBO) prevalence in patients with FD was significantly higher as compared to controls [4. [11,12] including systemic sclerosis [13], chronic liver disease [14] and Parkinson's disease. Three systematic reviews and meta-analyses have confirmed increased prevalence of SIBO in patients with chronic liver disease [14][15][16], irrespective of the aetiology of liver disease [15] and SIBO prevalence was significantly increased in patients with decompensated cirrhosis as compared to those with compensated cirrhosis [16], (50.5% vs. 31.2%; P < 0.001).…”

“…However, there is insufficient evidence on effectiveness of prokinetics and octreotide at eradicating small intestinal bacterial overgrowth in systemic sclerosis. A recent systematic review and meta-analysis [13], has shown that in patients with scleroderma and subsequent SIBO, at least short-term administration of octreotide exerting a prokinetic effect [46,47], improved abdominal symptoms significantly and normalized hydrogen breath test. In a landmark study, Soudah et al [46], prospectively treated 11 individuals (5 with scleroderma and 6 controls) with octreotide (50 μg subcutaneously every evening) for three weeks.…”