Small‐intestinal bacterial overgrowth in cirrhosis is related to the severity of liver disease

PANDE, C.; KUMAR, A.; SARIN, S. K.

doi:10.1111/j.1365-2036.2009.03994.x

Cited by 152Liver Disease and TransplantationGut microbiota and healthGastrointestinal motility and disorders

Small‐intestinal bacterial overgrowth in cirrhosis is related to the severity of liver disease

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PANDE, C., KUMAR, A., SARIN, S. K.·2009·Alimentary Pharmacology & Therapeutics

DOI 10.1111/j.1365-2036.2009.03994.x

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Abstract

Summary: 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 ≥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 ≥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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Alcohol causes intestinal bacterial overgrowth in humans and bacterial numbers were significantly higher in jejunal aspirates from patients with chronic alcohol abuse compared with controls, with similar findings in patients with alcohol-induced cirrhosis.
“Alcohol causes intestinal bacterial overgrowth in humans and bacterial numbers were significantly higher in jejunal aspirates from patients with chronic alcohol abuse compared with controls, with similar findings in patients with alcohol-induced cirrhosis.45”
From The gut microbiota and host health: a new clinical frontier (2016) · cites this paper as [45]

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Bacterial translocation (BT) in cirrhosis†
Wiest, R., & Garcia‐Tsao, G. (2005) · Hepatology · doi:10.1002/hep.20632 · Cited by 677 · see citing works
Synbiotic modulation of gut flora: Effect on minimal hepatic encephalopathy in patients with cirrhosis
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 · see citing works
The hepatic venous pressure gradient: Anything worth doing should be done right
Groszmann, R. J., & Wongcharatrawee, S. (2004) · Hepatology · doi:10.1002/hep.20062 · Cited by 530 · see citing works
Use and abuse of hydrogen breath tests
Simrén, M., & Stotzer, P.-O. (2006) · Gut · doi:10.1136/gut.2005.075127 · Cited by 415 · see citing works
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 · see citing works
The diagnosis of small bowel bacterial overgrowth
Corazza, G. R., Menozzi, M. G., Strocchi, A., Rasciti, L., Vaira, D., Lecchini, R., Avanzini, P., Chezzi, C., & Gasbarrini, A. (1990) · Gastroenterology · doi:10.1016/0016-5085(90)90818-l · Cited by 351 · see citing works
Jejunal microflora in patients with chronic alcohol abuse.
Jc, B., Bode, C., Heidelbach, R., Hk, D., & Ga, M. (1984) · PubMed · Cited by 303 · see citing works
Breath hydrogen testing in bacterial overgrowth of the small intestine
Kerlin, P., & Wong, L. (1988) · Gastroenterology · doi:10.1016/0016-5085(88)90173-4 · Cited by 277 · see citing works
Small intestinal bacterial overgrowth in patients with cirrhosis: prevalence and relation with spontaneous bacterial peritonitis
Bauer, T., Steinbrückner, B., Brinkmann, F., Ditzen, A. K., Schwacha, H., Aponte, J. J., Pelz, K., Kist, M., & Blum, H. E. (2001) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2001.04668.x · Cited by 266 · see citing works
Small Intestine Dysmotility and Bacterial Overgrowth in Cirrhotic Patients With Spontaneous Bacterial Peritonitis
Chang, C., Chen, G., Lien, H., & Yeh, H. (1998) · Hepatology · doi:10.1002/hep.510280504 · Cited by 261 · see citing works
Small bowel bacterial overgrowth in patients with alcoholic cirrhosis
Morencos, F. C., Castano, G. D. L. H., Ramos, L. M., Arias, M. J. L., Ledesma, F., & Romero, F. P. (1996) · Digestive Diseases and Sciences · doi:10.1007/bf02282340 · Cited by 246 · see citing works
Small Intestinal Motility Disturbances and Bacterial Overgrowth in Patients With Liver Cirrhosis and Portal Hypertension
Gunnarsdóttir, S. A., Sadik, R., Shev, S., Simrén, M., Sjövall, H., Stotzer, P., Abrahamsson, H., Olsson, R., & Bjornsson, E. S. (2003) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2003.07475.x · Cited by 186 · see citing works
The bacterial content of the small intestine in normal and cirrhotic subjects: relation to methionine toxicity.
Martini, G. A., Phear, E. A., Ruebner, B. H., & Sherlock, S. (1957) · PubMed · Cited by 172 · see citing works
Peripheral Blood Mononuclear Cell Expression of Toll–Like Receptors and Relation to Cytokine Levels in Cirrhosis
Riordan, S. M., Skinner, N. A., Nagree, A., McCallum, H., McIver, C. J., Kurtovic, J., Hamilton, J. A., Bengmark, S., Williams, R. L., & Visvanathan, K. (2003) · Hepatology · doi:10.1053/jhep.2003.50180 · Cited by 167 · see citing works
Small bowel bacterial overgrowth in patients with alcoholic cirrhosis
Morencos, F. C., Castano, G. D. L. H., Ramos, L. M., Arias, M. J. L., Ledesma, F., & Romero, F. P. (1995) · Digestive Diseases and Sciences · doi:10.1007/bf02065533 · Cited by 132 · see citing works
Abnormalities in proximal small bowel motility in patients with cirrhosis
Jaime Chesta, R., Defilippi, C., & Defilíppí, C. (1993) · Hepatology · doi:10.1002/hep.1840170513 · Cited by 127 · see citing works
Extra intestinal influences on exhaled breath hydrogen measurements during the investigation of gastrointestinal disease.
Thompson, D., Binfield, P., de Belder, A., O'Brien, J. D., Warren, S., & Wilson, M. (1985) · Gut · doi:10.1136/gut.26.12.1349 · Cited by 120 · see citing works
Utility of hydrogen breath tests in diagnosis of small intestinal bacterial overgrowth in malabsorption syndrome and its relationship with oro-cecal transit time.
Ghoshal, U. C., Ghoshal, U., Das, K., & Misra, A. (2006) · PubMed · Cited by 119 · see citing works
Altered Small Bowel Motility in Patients with Liver Cirrhosis Depends on Severity of Liver Disease
Madrid, A. M., Cumsille, F., & Defilíppí, C. (1997) · Digestive Diseases and Sciences · doi:10.1023/a:1018899611006 · Cited by 110 · see citing works
Gut flora and bacterial translocation in chronic liver disease
Almeida, J. A. (2006) · World Journal of Gastroenterology · doi:10.3748/wjg.v12.i10.1493 · Cited by 105 · see citing works
Results of small intestinal bacterial overgrowth testing in irritable bowel syndrome patients: clinical profiles and effects of antibiotic trial.
Majewski, M. S., & McCallum, R. W. (2007) · PubMed · Cited by 101 · see citing works
Etiology of portal hypertension may influence gastrointestinal transit
Sadik, R., Abrahamsson, H., Björnsson, E., Gunnarsdóttir, A., & Stotzer, P. (2003) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365520310004939 · Cited by 93 · see citing works
Influence of the oropharyngeal microflora on the measurement of exhaled breath hydrogen
Thompson, D. G., O'Brien, J. D., & Hardie, J. M. (1986) · Gastroenterology · doi:10.1016/0016-5085(86)90686-4 · Cited by 87 · see citing works
Small-Intestinal Bacterial Overgrowth in Patients with Liver Cirrhosis, Diagnosed with Glucose H2or CH4Breath Tests
Yang, C. (1998) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365529850171549 · Cited by 83 · see citing works
Diagnosis of small intestinal bacterial overgrowth in patients with cirrhosis of the liver: poor performance of the glucose breath hydrogen test
Bauer, T., Schwacha, H., Steinbrückner, B., Brinkmann, F., Ditzen, A. K., Kist, M., & Blum, H. E. (2000) · Journal of Hepatology · doi:10.1016/s0168-8278(00)80273-1 · Cited by 80 · see citing works
Breath hydrogen excretion in patients with alcoholic liver disease--evidence of small intestinal bacterial overgrowth.
Bode, C., Kolepke, R., Schäfer, K., & Bode, J. C. (1993) · PubMed · Cited by 79 · see citing works
Qualitative and Quantitative Relationships of the Fecal Flora in Cirrhotic Patients with Portal Systemic Encephalopathy and Following Portacaval Anastomosis
Floch, M. H., Katz, J., & Conn, H. O. (1970) · Gastroenterology · doi:10.1016/s0016-5085(19)33805-3 · Cited by 47 · see citing works
[Bacterial overgrowth in small intestine in patients with liver cirrhosis].
Jaime Chesta, R., Silva, M., Thompson, L., del Canto, E., & Defilíppí, C. (1991) · PubMed · Cited by 40 · see citing works
Intestinal myoelectrical activity and transit time in chronic portal hypertension
Stewart, J. J., Battarbee, H. D., Farrar, G. E., & Betzing, K. W. (1992) · American Journal of Physiology-Gastrointestinal and Liver Physiology · doi:10.1152/ajpgi.1992.263.4.g474 · Cited by 27 · see citing works
Faecal Hydrogen Production in vitro as an Indicator for in vivo Hydrogen Producing Capability in the Breath Hydrogen Test
Robb, T. A., Goodwin, D., & Davidson, G. P. (1985) · Acta Paediatrica · doi:10.1111/j.1651-2227.1985.tb10061.x · Cited by 9 · see citing works

Flagged first, then by citations

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Yang CY, Chang CS, Chen GH. Small- intestinal bacterial overgrowth in patients with liver cirrhosis, diagnosed with glu- cose H2 or CH4 breath tests. Scand J Gas- troenterol 1998; 33: 867-71.

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Marchesi, J. R., Adams, D. H., Fava, F., Hermes, G. D. A., Hirschfield, G. M., Hold, G., Quraishi, M. N., Kinross, J., Smidt, H., Tuohy, K. M., et al. (2016) · Gut · doi:10.1136/gutjnl-2015-309990 · Cited by 2,302 · see citing works
“45 The degree of over-growth correlates with the severity of cirrhosis.”
Background
Characterization of fecal microbial communities in patients with liver cirrhosis
Chen, Y., Yang, F., Lu, H., Wang, B., Chen, Y., Lei, D., Wang, Y., Zhu, B., & Li, L. (2011) · Hepatology · doi:10.1002/hep.24423 · Cited by 1,038 · see citing works
Bacterial infections in cirrhosis: A position statement based on the EASL Special Conference 2013
Jalan, R., Fernandez, J., Wiest, R., Schnabl, B., Moreau, R., Angeli, P., Stadlbauer, V., Gustot, T., Bernardi, M., Canton, R., et al. (2014) · Journal of Hepatology · doi:10.1016/j.jhep.2014.01.024 · Cited by 906 · see citing works
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Wiest, R., Lawson, M. A., & Geuking, M. B. (2013) · Journal of Hepatology · doi:10.1016/j.jhep.2013.07.044 · Cited by 815 · see citing works
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Bures, J. (2010) · World Journal of Gastroenterology · doi:10.3748/wjg.v16.i24.2978 · Cited by 620 · see citing works
Bacterial translocation and changes in the intestinal microbiome in mouse models of liver disease
Fouts, D. E., Torralba, M., Nelson, K. E., Brenner, D. A., & Schnabl, B. (2012) · Journal of Hepatology · doi:10.1016/j.jhep.2012.01.019 · Cited by 311 · see citing works
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Dupont, A. W., & DuPont, H. L. (2011) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/nrgastro.2011.133 · Cited by 306 · see citing works
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Giannelli, V. (2014) · World Journal of Gastroenterology · doi:10.3748/wjg.v20.i45.16795 · Cited by 237 · see citing works
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Ghoshal, U. C. (2011) · Journal of Neurogastroenterology and Motility · doi:10.5056/jnm.2011.17.3.312 · Cited by 232 · see citing works
Probiotics Prevent Hepatic Encephalopathy in Patients with Cirrhosis: A Randomized Controlled Trial
Lunia, M. K., Sharma, B. C., Sharma, P., Sachdeva, S., & Srivastava, S. (2014) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2013.11.006 · Cited by 218 · see citing works
Microbial-derived metabolites as a risk factor of age-related cognitive decline and dementia
Connell, E., Le Gall, G., Pontifex, M. G., Sami, S., Cryan, J. F., Clarke, G., Müller, M., & Vauzour, D. (2022) · Molecular Neurodegeneration · doi:10.1186/s13024-022-00548-6 · Cited by 208 · see citing works
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Show Me What You Have Inside—The Complex Interplay between SIBO and Multiple Medical Conditions—A Systematic Review
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Self-citation
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Irritable Bowel Syndrome May Be Associated with Elevated Alanine Aminotransferase and Metabolic Syndrome
Lee, S. H., Kim, K.-N., Kim, K.-M., & Joo, N. (2015) · Yonsei Medical Journal · doi:10.3349/ymj.2016.57.1.146 · Cited by 44 · see citing works
Effects of probiotic therapy on hepatic encephalopathy in patients with liver cirrhosis: an updated meta-analysis of six randomized controlled trials
Xu, J., Ma, R., Chen, L.-F., Zhao, L., Chen, K., & Zhang, R. (2014) · Hepatobiliary & pancreatic diseases international · doi:10.1016/s1499-3872(14)60280-0 · Cited by 44 · see citing works
Gut microbiota-modulating agents in alcoholic liver disease: Links between host metabolism and gut microbiota
Jung, J. H., Kim, S. E., Suk, K. T., & Kim, D. J. (2022) · Frontiers in Medicine · doi:10.3389/fmed.2022.913842 · Cited by 42 · see citing works
Probiotics, prebiotics, and synbiotics in nonalcoholic fatty liver disease and alcohol-associated liver disease
Kaufmann, B. K., Seyfried, N., Hartmann, D., & Hartmann, P. (2023) · American Journal of Physiology-Gastrointestinal and Liver Physiology · doi:10.1152/ajpgi.00017.2023 · Cited by 39 · see citing works
Effects of SIBO and rifaximin therapy on MHE caused by hepatic cirrhosis.
Zhang, Y., Feng, Y., Cao, B., & Tian, Q. (2015) · PubMed Central · Cited by 35 · see citing works
Small Bowel Transit and Altered Gut Microbiota in Patients With Liver Cirrhosis
Liu, Y., Jin, Y., Li, J., Zhao, L., Li, Z., Xu, J., Zhao, F., Feng, J., Chen, H., Fang, C., et al. (2018) · Frontiers in Physiology · doi:10.3389/fphys.2018.00470 · Cited by 35 · see citing works
Levothyroxine therapy and impaired clearance are the strongest contributors to small intestinal bacterial overgrowth: Results of a retrospective cohort study
Brechmann, T., Sperlbaum, A., & Schmiegel, W. (2017) · World Journal of Gastroenterology · doi:10.3748/wjg.v23.i5.842 · Cited by 34 · see citing works
The enteric microbiome in hepatobiliary health and disease
Tabibian, J. H., Varghese, C., LaRusso, N. F., & O’Hara, S. P. (2015) · Liver International · doi:10.1111/liv.13009 · Cited by 33 · see citing works
Erythromycin versus neomycin in the treatment of hepatic encephalopathy in cirrhosis: a randomized double-blind study
Romeiro, F. G., Yamashiro, F. D. S., Américo, M. F., Corá, L. A., Silva, G. F., Miranda, J. R. D. A., & Caramori, C. A. (2013) · BMC Gastroenterology · doi:10.1186/1471-230x-13-13 · Cited by 31 · see citing works
Nutrition status and small intestinal bacterial overgrowth in patients with virus-related cirrhosis.
Yao, J., Chang, L., Yuan, L., & Duan, Z. (2016) · PubMed · doi:10.6133/apjcn.2016.25.2.06 · Cited by 31 · see citing works
Microbiome and bile acid profiles in duodenal aspirates from patients with liver cirrhosis: The Microbiome, Microbial Markers and Liver Disease Study
Jacobs, J. P., Dong, T. S., Agopian, V. G., Lagishetty, V., Sundaram, V., Noureddin, M., Ayoub, W. S., Durazo, F. A., Benhammou, J. N., Enayati, P. J., et al. (2018) · Hepatology Research · doi:10.1111/hepr.13207 · Cited by 31 · see citing works
Effect of a specific Escherichia coli Nissle 1917 strain on minimal/mild hepatic encephalopathy treatment
Манжалій, Е., Moyseyenko, V. O., Кondratiuk, V. Y., Molochek, N., Falalyeyeva, T. M., & Kobyliak, N. M. (2022) · World Journal of Hepatology · doi:10.4254/wjh.v14.i3.634 · Cited by 31 · see citing works
Association of proton pump inhibitors with the risk of hepatic encephalopathy during hospitalization for liver cirrhosis
Zhu, J., Qi, X., Yu, H., Yoshida, E. M., Mendez-Sanchez, N., Zhang, X., Wang, R., Deng, H., Li, J., Han, D., et al. (2018) · United European Gastroenterology Journal · doi:10.1177/2050640618773564 · Cited by 28 · see citing works
The effect of small intestinal bacterial overgrowth on minimal hepatic encephalopathy in patients with cirrhosis
Zhang, Y., Feng, Y., Cao, B., & Tian, Q. (2015) · Archives of Medical Science · doi:10.5114/aoms.2015.55675 · Cited by 27 · see citing works
Small intestinal bacterial overgrowth and delayed orocecal transit time in patients with cirrhosis and low-grade hepatic encephalopathy
Lunia, M. K., Sharma, B. C., & Sachdeva, S. (2012) · Hepatology International · doi:10.1007/s12072-012-9360-9 · Cited by 26 · see citing works
Novel prevention strategies for bacterial infections in cirrhosis
Yan, K. G., & García–Tsao, G. (2016) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.2016.1145663 · Cited by 26 · see citing works
Hydrogen- and Methane-Based Breath Testing and Outcomes in Patients With Heart Failure
Mollar, A., Villanueva, M. P., Núñez, E., Carratalá, A., Mora, F., Bayés‐Genís, A., Mínguez, M., Marrachelli, V. G., Monleón, D., Navarro, D., et al. (2018) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2018.10.004 · Cited by 26 · see citing works
Association Between Small Intestinal Bacterial Overgrowth by Glucose Breath Test and Coronary Artery Disease
Fialho, A., Fialho, A. B. C., Kochhar, G. S., Schenone, A. L., Thota, P. N., McCullough, A. J., & Shen, B. (2017) · Digestive Diseases and Sciences · doi:10.1007/s10620-017-4828-z · Cited by 23 · see citing works
Is small intestinal bacterial overgrowth a cause of hyperdynamic circulation in cirrhosis?
Maslennikov, R. V., Pavlov, C. S., & Ivashkin, V. T. (2019) · The Turkish Journal of Gastroenterology · doi:10.5152/tjg.2019.18551 · Cited by 23 · see citing works
Prevalence of Small Intestinal Bacterial Overgrowth among Chronic Pancreatitis Patients: A Case-Control Study
Therrien, A., Bouchard, S., Sidani, S., & Bouin, M. (2016) · Canadian Journal of Gastroenterology and Hepatology · doi:10.1155/2016/7424831 · Cited by 21 · see citing works
New Developments in Microbiome in Alcohol-Associated and Nonalcoholic Fatty Liver Disease
Hartmann, P., & Schnabl, B. (2021) · Seminars in Liver Disease · doi:10.1055/s-0040-1719174 · Cited by 22 · see citing works
Nonalcoholic fatty liver disease, diet and gut microbiota
Finelli, C., & Tarantino, G. (2014) · Europe PMC (PubMed Central) · doi:10.17877/de290r-15828 · Cited by 20 · see citing works
Retracted
Role of alcohol in the development and progression of hepatocellular carcinoma
McKillop, I. H., Schrum, L. W., & Thompson, K. J. (2015) · Hepatic Oncology · doi:10.2217/hep.15.40 · Cited by 19 · see citing works
Improved hemodynamic and liver function in portal hypertensive cirrhotic rats after administration of B. pseudocatenulatum CECT 7765
Gómez‐Hurtado, I., Zapater, P., Portune, K. J., Juanola, O., Fernández‐Iglesias, A., González-Navajas, J. M., Gracia‐Sancho, J., Sanz, Y., & Francés, R. (2018) · European Journal of Nutrition · doi:10.1007/s00394-018-1709-y · Cited by 18 · see citing works
Current Status and Prospects of Spontaneous Peritonitis in Patients with Cirrhosis
Li, Y., Huang, J., & Peng, M. (2020) · BioMed Research International · doi:10.1155/2020/3743962 · Cited by 16 · see citing works
Patients with breath test positive are necessary to be identified from irritable bowel syndrome: a clinical trial based on microbiomics and rifaximin sensitivity
Liu, Z., Zhu, S., He, M., Li, M., Wei, H., Zhang, L., Sun, Q., Jia, Q., Hu, N., Fang, Y., et al. (2022) · Chinese Medical Journal · doi:10.1097/cm9.0000000000002294 · Cited by 15 · see citing works
Rifaximin: A reasonable alternative for norfloxacin in the prevention of spontaneous bacterial peritonitis in patients with HCV-related liver cirrhosis
Shamseya, M. M., & Madkour, M. A. (2015) · Alexandria Journal of Medicine · doi:10.1016/j.ajme.2015.09.002 · Cited by 15 · see citing works
Small Intestinal Bacterial Overgrowth Is Associated with Poor Prognosis in Cirrhosis
Efremova, I., Maslennikov, R. V., Alieva, A. M., Poluektova, E., & Ivashkin, V. T. (2023) · Microorganisms · doi:10.3390/microorganisms11041017 · Cited by 13 · see citing works
Modulating the gut–liver axis and the pivotal role of the faecal microbiome in cirrhosis
Woodhouse, C., Singanayagam, A., & Patel, V. (2020) · Clinical Medicine · doi:10.7861/clinmed.2020-0676 · Cited by 12 · see citing works
Microbiome and gut-liver interactions: From mechanisms to therapies
Anis, M. A., Shahid, Y., Majeed, A. A., & Abid, S. (2025) · World Journal of Gastroenterology · doi:10.3748/wjg.v31.i40.111409 · Cited by 12 · see citing works
Small intestinal bacterial overgrowth in chronic liver disease: an updated systematic review and meta-analysis of case-control studies
Shah, A., Spannenburg, L., Thite, P., Morrison, M., Fairlie, T., Koloski, N. A., Kashyap, P., Pimentel, M., Rezaie, A. R., Gores, G. J., et al. (2024) · EClinicalMedicine · doi:10.1016/j.eclinm.2024.103024 · Cited by 12 · see citing works
Small Intestinal Bacterial Overgrowth (SIBO)
Roland, C. (2014) · Journal of Gastrointestinal & Digestive System · doi:10.4172/2161-069x.1000225 · Cited by 11 · see citing works
Probiotics for the Treatment of Liver Disease
Punzalan, C., & Qamar, A. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-804024-9.00040-9 · Cited by 11 · see citing works
Serum Scoring and Quantitative Magnetic Resonance Imaging in Intestinal Failure-Associated Liver Disease: A Feasibility Study
Fragkos, K. C., Bouroncle, M. C. P., Kumar, S., Caselton, L., Menys, A., Bainbridge, A. P., Taylor, S. A., Torrealdea, F. J., Kumagai, T., Caro, S. D., et al. (2020) · Nutrients · doi:10.3390/nu12072151 · Cited by 10 · see citing works
Gastrointestinal Dysfunction in Chronic Liver Disease
Nguyen, D. H. N. Q. (2015) · Journal of Gastrointestinal & Digestive System · doi:10.4172/2161-069x.1000257 · Cited by 10 · see citing works
Characteristics of fecal microbial communities in patients with non-anastomotic biliary strictures after liver transplantation
Zhang, J., Ren, F., Liu, P., Zhang, H.-K., Zhu, H., Feng, Z., Zhang, X., Wang, B., Liu, X., Zhang, X., et al. (2017) · World Journal of Gastroenterology · doi:10.3748/wjg.v23.i46.8217 · Cited by 10 · see citing works
Is periodontitis a risk factor for infections in cirrhotic patients?
Profio, B. D., Villar, C. C., Saraiva, L. M., Ortega, K. L., & Pannuti, C. M. (2017) · Medical Hypotheses · doi:10.1016/j.mehy.2017.06.022 · Cited by 9 · see citing works
Antibiotics in Chronic Liver Disease and Their Effects on Gut Microbiota
Méndez‐Sánchez, N., Coronel-Castillo, C. E., Córdova‐Gallardo, J., & Qi, X. (2023) · Antibiotics · doi:10.3390/antibiotics12101475 · Cited by 8 · see citing works
Proton pump inhibitor treatment is associated with acute-on-chronic liver failure in patients with advanced cirrhosis
Sturm, L., Gahm, C., Schultheiß, M., Reincke, M., Huber, J. P., Boettler, T., Thimme, R., & Bettinger, D. (2023) · Hepatology Communications · doi:10.1097/hc9.0000000000000178 · Cited by 8 · see citing works
Proton pump inhibitor treatment aggravates bacterial translocation in patients with advanced cirrhosis and portal hypertension
Sturm, L., Hirose, M., Stolz, L., Schultheiß, M., Zoldan, K., Reincke, M., Huber, J. P., Kaeser, R., Boettler, T., Thimme, R., et al. (2023) · mBio · doi:10.1128/mbio.00492-23 · Cited by 8 · see citing works
The prevalence and impact of small intestine bacterial overgrowth in biliary atresia patients
Wu, J., Tseng, P., Chang, H., Chiang, C., Lin, W., Hsu, W., & Chang, M. (2023) · Pediatric Research · doi:10.1038/s41390-023-02818-5 · Cited by 6 · see citing works
Small Intestinal Bacterial Overgrowth and Pediatric Obesity—A Systematic Review
Koller, A. M., Săsăran, M. O., & Mărginean, C. O. (2025) · Nutrients · doi:10.3390/nu17091499 · Cited by 5 · see citing works
Small Intestinal Bacterial Overgrowth (SIBO) - Prevention and Therapeutic Role of Nutrition, Prebiotics, Probiotics, and Prokinetics
Mustafa, F., Noor, R., Murtaza, A., Kanwal, W., Kanwal, F., Kaleem, T., Munir, F., Umar, R. A. B., Taib, W. R. W., Krishnasamy, S., et al. (2025) · Current Pharmaceutical Design · doi:10.2174/0113816128373584250407134451 · Cited by 5 · see citing works
Intestinal Dendritic Cells Are Altered in Number, Maturity and Chemotactic Ability in Fulminant Hepatic Failure
Liu, M., Wang, P., Zhao, M., & Liu, D. (2016) · PLoS ONE · doi:10.1371/journal.pone.0166165 · Cited by 5 · see citing works
Is it possible to intervene early cirrhosis by targeting toll-like receptors to rebalance the intestinal microbiome?
Zhang, J., Zao, X., Zhang, J., Guo, Z., Jin, Q., Chen, G., Gan, D., Du, H., & Ye, Y. (2022) · International Immunopharmacology · doi:10.1016/j.intimp.2022.109627 · Cited by 5 · see citing works

Small-Intestinal Bacterial Overgrowth in Patients with Liver Cirrhosis, Diagnosed with Glucose H2or CH4Breath Tests
Yang, C. (1998) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365529850171549 · Cited by 83 · see citing works
Small intestinal bacterial overgrowth in cirrhosis: systematic review and meta-analysis
Maslennikov, R. V., Pavlov, C. S., & Ivashkin, V. T. (2018) · Hepatology International · doi:10.1007/s12072-018-9898-2 · Cited by 74 · see citing works
Prevalence of Small Intestinal Bacterial Overgrowth in Patients with Liver Cirrhosis
Gerova, В., Nakov, V., Stoynov, S. G., & Nakov, R. (2013) · Journal of Gastroenterology and Hepatology Research · Cited by 4 · see citing works
Study of Frequency and Factors Associated with Small Intestinal Bacterial Overgrowth in Patients with Cirrhosis of the Liver – A Prospective Observational Cohort Study
Maity, H., Pal, S., & Bohidar, N. P. (2025) · International Journal of Pharmaceutical Quality Assurance · doi:10.25258/ijpqa.16.10.20
Small Intestinal Bacterial Overgrowth among Patients with Cirrhosis
Patwary, R. I., Rahman, M. M., Dutta, R., Ahmed, H. I., Imam, I., & Islam, M. A. (2022) · Scholars Journal of Applied Medical Sciences · doi:10.36347/sjams.2022.v10i04.030 · Cited by 1 · see citing works

Authors: PANDE, C., KUMAR, A., & SARIN, S. K.
Affiliations: Jawaharlal Nehru University (IN)
Corresponding author: SARIN, S. K.
ORCID: KUMAR, A.
SARIN, S. K.
Venue: Alimentary Pharmacology & Therapeutics
Publisher: Wiley
Published: 2009-05-21
Volume: 29
Issue: 12
Pages: 1273-1281
ISSN: 0269-2813 (ISSN-L)
1365-2036
DOI: 10.1111/j.1365-2036.2009.03994.x
OpenAlex: W2011658871
Cited by: 152
References: 30
Citations by year: 2026: 3 · 2025: 7 · 2024: 4 · 2023: 9 · 2022: 11 · 2021: 6 · 2020: 8 · 2019: 8 · 2018: 13 · 2017: 12 · 2016: 11 · 2015: 19 · 2014: 11 · 2013: 7 · 2012: 10
FWCI: 4.74
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Alimentary Pharmacology & Therapeutics (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Keywords: small intestinal bacterial overgrowth, liver cirrhosis, Child-Pugh score, glucose hydrogen breath test, serum bilirubin, ascites, SIBO prevalence, diagnostic prediction
MeSH terms: Adult, Bacteria, Bacterial Infections, Breath Tests, Humans, Intestinal Diseases, Liver Cirrhosis, Male, Middle Aged, Severity of Illness Index, Statistics as Topic

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Small‐intestinal bacterial overgrowth in cirrhosis is related to the severity of liver disease

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