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.
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Authors | C Pande, A Kumar, S K Sarin |
Journal | Alimentary pharmacology & therapeutics
(Aliment Pharmacol Ther)
Vol. 29
Issue 12
Pg. 1273-81
(Jun 15 2009)
ISSN: 1365-2036 [Electronic] England |
PMID | 19302262
(Publication Type: Journal Article)
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Topics |
- Adult
- Bacteria
(growth & development)
- Bacterial Infections
(complications)
- Breath Tests
- Humans
- Intestinal Diseases
(microbiology)
- Liver Cirrhosis
(complications)
- Male
- Middle Aged
- Severity of Illness Index
- Statistics as Topic
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