The DOI matches its Crossref record; 49 of the 50 references it cites were found in a registry or an index.
Role of small intestinal bacterial overgrowth and delayed gastrointestinal transit time in cirrhotic patients with minimal hepatic encephalopathy
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 [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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Cites
Ferenci, P., Lockwood, A. H., Mullen, K. D., Tarter, R. E., Weißenborn, K., & Blei, A. T. (2002) · Hepatology · doi:10.1053/jhep.2002.31250 · Cited by 2,035
Neuropsychological characterization of hepatic encephalopathy
Weißenborn, K., Ennen, J. C., Schomerus, H., Rückert, N., & Hecker, H. (2001) · Journal of Hepatology · doi:10.1016/s0168-8278(01)00026-5 · Cited by 796
Liu, Q., Duan, Z. P., Ha, D. K., Bengmark, S., Kurtovic, J., & Riordan, S. M. (2004) · Hepatology · doi:10.1002/hep.20194 · Cited by 636
Prasad, S., Dhiman, R. K., Duseja, A. K., Chawla, Y. K., Sharma, A., & Agarwal, R. (2007) · Hepatology · doi:10.1002/hep.21533 · Cited by 602
Self-citationSubclinical hepatic encephalopathy predicts the development of overt hepatic encephalopathy
Romero‐Gómez, M., Boza, F., Garci'a-Valdecasas, M. S., Garci'a, E., & Aguilar‐Reina, J. (2001) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2001.04130.x · Cited by 411
Incomplete Absorption of the Carbohydrate in All-Purpose Wheat Flour
Anderson, I. H., Levine, A. S., & Levitt, M. D. (1981) · New England Journal of Medicine · doi:10.1056/nejm198104093041507 · Cited by 378
Cerebral Ammonia Metabolism in Patients with Severe Liver Disease and Minimal Hepatic Encephalopathy
Lockwood, A. H., Yap, E. W. H., & Wong, W. (1991) · Journal of Cerebral Blood Flow & Metabolism · doi:10.1038/jcbfm.1991.67 · Cited by 335
Small Intestinal Bacterial Overgrowth: Roles of Antibiotics, Prebiotics, and Probiotics
Quigley, E. M. M., & Quera, R. (2006) · Gastroenterology · doi:10.1053/j.gastro.2005.11.046 · Cited by 330
Value of the critical flicker frequency in patients with minimal hepatic encephalopathy†
Romero‐Gómez, M., Córdoba, J., Jover, R., del Olmo, J. A., Ramirez, M. C., Rey, R., de‐Madaria, E., Montoliu, C., Nuñez, D., Flavià, M., et al. (2007) · Hepatology · doi:10.1002/hep.21586 · Cited by 323
Prevalence and natural history of subclinical hepatic encephalopathy in cirrhosis
Das, A., Dhiman, R. K., Saraswat, V. A., Verma, M., & Naik, S. R. (2001) · Journal of Gastroenterology and Hepatology · doi:10.1046/j.1440-1746.2001.02487.x · Cited by 298
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Sharma, B. C., Maharshi, S., Sachdeva, S., Mahajan, B., Sharma, A., Bara, S., Srivastava, S., Kumar, A., Dalal, A., & Sonika, U. (2023) · Journal of Gastroenterology and Hepatology · doi:10.1111/jgh.16266 · Cited by 11
Metadata
- 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
- Venue
- Journal of Hepatology
- Publisher
- Elsevier BV
- Published
- 2010-11
- Volume
- 53
- Issue
- 5
- Pages
- 849-855
- ISSN
- 0168-8278 (ISSN-L)
- 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
- 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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