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Cited by 202Liver Disease and TransplantationGastrointestinal motility and disordersGut microbiota and health

Role of small intestinal bacterial overgrowth and delayed gastrointestinal transit time in cirrhotic patients with minimal hepatic encephalopathy

Gupta, Ankur, Dhiman, Radha K, Kumari, Savita, Rana, Satyavati, Agarwal, Ritesh, Duseja, Ajay, Chawla, Yogesh·2010·Journal of Hepatology
DOI 10.1016/j.jhep.2010.05.017
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Abstract

Background & aims Minimal hepatic encephalopathy (MHE) is the mildest form in the spectrum of hepatic encephalopathy. This cross-sectional study was carried out to elucidate the role of bacterial overgrowth of the small intestine and delayed intestinal transit among patients with MHE. Methods Two-hundred-thirty patients with cirrhosis were screened; 102 patients (44.4%) who met the eligibility criteria were included in the study. MHE was diagnosed when the psychometric hepatic encephalopathy score was ≤-5. All patients underwent a glucose breath test for small intestinal bacterial overgrowth (SIBO) and lactulose breath test for oro-cecal transit time (OCTT). Results Fifty-seven (55.9%) patients with cirrhosis had MHE. Among these patients with MHE, 22 (38.6%) had SIBO, while 4 (8.9%) without MHE had SIBO (p = 0.001). The prevalence of SIBO was higher in patients with CTP classes B and C (69.2%) compared to those in CTP class A (30.8%); p = 0.054. OCTT was significantly prolonged in patients who had SIBO than in those who did not have SIBO (p Conclusions Our study conclusively demonstrates high prevalence of SIBO in patients with cirrhosis with MHE. This study gives the rationale of treatment directed against SIBO and gut dysmotility, which may include non-absorbable antibiotics such as rifaximin, probiotics, and prokinetics.

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  • Among the potential contributors of the microbiota to complications of liver cirrhosis is the presence of SIBO, and a dysfunctional mucosal barrier which can contribute to bacterial (or endotoxin) translocation to the portal circulation.

    “Among the potential contributors of the microbiota to complications of liver cirrhosis is the presence of SIBO [73] , and a dysfunctional mucosal barrier which can contribute to bacterial (or endotoxin) translocation to the portal circulation [74] .”

    From Intestinal microbiota in health and disease: Role of bifidobacteria in gut homeostasis (2014) · cites this paper as [73]

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Authors
Gupta, A., Dhiman, R. K., Kumari, S., Rana, S., Agarwal, R., Duseja, A., & Chawla, Y.
Affiliations
Post Graduate Institute of Medical Education and Research (IN)
Corresponding author
Dhiman, Radha K
ORCID
Venue
Journal of Hepatology
Publisher
Elsevier BV
Published
2010-11
Volume
53
Issue
5
Pages
849-855
ISSN
0168-8278 (ISSN-L)
DOI
10.1016/j.jhep.2010.05.017
OpenAlex
W1989507260
Cited by
202
References
50
Citations by year
2026: 3 · 2025: 3 · 2024: 11 · 2023: 19 · 2022: 14 · 2021: 5 · 2020: 9 · 2019: 17 · 2018: 13 · 2017: 12 · 2016: 16 · 2015: 18 · 2014: 22 · 2013: 8 · 2012: 18
FWCI
8.40
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Hepatology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
Keywords
minimal hepatic encephalopathy, small intestinal bacterial overgrowth, liver cirrhosis, glucose breath test, lactulose breath test, Child-Pugh score, gastrointestinal motility disorders, rifaximin, probiotics, prokinetic agents
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Bacteria, Cross-Sectional Studies, Female, Gastrointestinal Transit, Hepatic Encephalopathy, Humans, Intestine, Small, Liver Cirrhosis, Male, Middle Aged, Prevalence, Multivariate Analysis

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