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A meta‐analysis on small intestinal bacterial overgrowth in patients with different subtypes of irritable bowel syndrome
Author(s) -
Ghoshal Uday C,
Nehra Abhimanyu,
Mathur Akash,
Rai Sushmita
Publication year - 2020
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.14938
Subject(s) - irritable bowel syndrome , medicine , small intestinal bacterial overgrowth , gastroenterology , meta analysis , short bowel syndrome , parenteral nutrition
Abstract Background Enteric microbiota is increasingly being recognized as an important factor in the pathogenesis of irritable bowel syndrome (IBS). The reported prevalence of small intestinal bacterial overgrowth (SIBO) in subjects with IBS is highly variable, and there is no consensus on the role of SIBO in different subtypes of IBS, and indications and methods of testing. Methods A comprehensive literature search was performed for studies applying tests for SIBO in subjects with IBS. After applying prospectively decided exclusion criteria, the eligible papers were examined using a meta‐analysis approach for the prevalence of SIBO in subjects with IBS using different tests. The odds ratios of SIBO among subjects with IBS as compared with healthy controls using different tests were calculated. Results Of the available studies (22, 17, 5, and 3 using lactulose and glucose hydrogen breath tests [LHBT and GHBT], jejunal aspirate culture, and more than one tests, respectively) meeting the inclusion criteria, 36.7% (95% confidence interval [CI] 24.2–44.6) had a positive test for SIBO. Patients with IBS were 2.6 (95% CI 1.3–6.9) and 8.3 (95% CI 3.0–5.9) times more likely to have a positive test for SIBO as compared with healthy controls using GHBT and jejunal aspirate culture, respectively. Patients with diarrhea‐predominant IBS were more likely to have positive GHBT as compared with the other subtypes. Conclusions Patients with IBS were more likely to have SIBO as compared with healthy subjects using GHBT and jejunal aspirate culture but not using LHBT. Patients with diarrhea‐predominant IBS more often have SIBO.