4.6 Article

Small Intestinal Bacterial Overgrowth Is Associated with Poor Prognosis in Cirrhosis

Journal

MICROORGANISMS
Volume 11, Issue 4, Pages -

Publisher

MDPI
DOI: 10.3390/microorganisms11041017

Keywords

SIBO; gut microbiota; bacterial translocation; prognosis; gut microbiome

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The aim of this study was to determine whether the presence of small intestinal bacterial overgrowth (SIBO) affects the prognosis in cirrhosis. A total of 50 patients were included in this prospective cohort study and underwent lactulose hydrogen breath test for SIBO. The results showed that SIBO is associated with poor prognosis in cirrhosis.
Background: Small intestinal bacterial overgrowth (SIBO) is associated with numerous manifestations of cirrhosis. To determine whether the presence of SIBO affects the prognosis in cirrhosis was the aim of the study. Methods: This prospective cohort study included 50 patients. All participants underwent a lactulose hydrogen breath test for SIBO. The follow-up period was 4 years. Results: SIBO was detected in 26 (52.0%) patients: in 10 (52.6%) patients with compensated cirrhosis and in 16 (51.6%) ones with decompensated cirrhosis. Twelve (46.2%) patients with SIBO and four (16.7%) patients without SIBO died within 4 years (p = 0.009). Among patients with decompensated cirrhosis, 8 (50.0%) patients with SIBO and 3 (20.0%) patients without SIBO died (p = 0.027). Among patients with compensated cirrhosis, four (40.0%) patients with SIBO and one (11.1%) patient without SIBO died (p = 0.045). Among patients with SIBO, there was no difference in mortality between patients with compensated and decompensated cirrhosis (p = 0.209). It was the same for patients without SIBO (p = 0.215). SIBO affects the prognosis only in the first year of follow-up in decompensated cirrhosis, and only in subsequent years in compensated cirrhosis. Presence of SIBO (p = 0.028; HR = 4.2(1.2-14.9)) and serum albumin level (p = 0.027) were significant independent risk factors for death in cirrhosis. Conclusions: SIBO is associated with poor prognosis in cirrhosis.

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