Small intestinal bacterial overgrowth in human cirrhosis is associated with systemic endotoxemia
Abstract
OBJECTIVES: Systemic endotoxemia has been implicated in various pathophysiological sequelae of chronic liver disease. One of its potential causes is increased intestinal absorption of endotoxin. We therefore examined the association of small intestinal bacterial overgrowth with systemic endotoxemia in patients with cirrhosis. METHODS: Fifty-three consecutive patients with cirrhosis (Child-Pugh group A, 23; group B, 18; group C, 12) were included. Jejunal secretions were cultivated quantitatively and systemic endotoxemia determined by the chromogenic Limulus amoebocyte assay. Patients were followed up for 1 yr. RESULTS: Small intestinal bacterial overgrowth, defined as > or = 10(5) total colony forming units per milliliter of jejunal secretions, was present in 59% of patients and strongly associated with acid suppressive therapy. The mean plasma endotoxin level was 0.86 +/- 0.48 endotoxin units/ml (range = 0.03-1.44) and was significantly associated with small intestinal bacterial overgrowth (0.99 vs 0.60 endotoxin units/ml, p = 0.03). During the 1-yr follow-up, seven patients were lost to follow up or underwent liver transplantation and 12 patients died. Multivariate Cox regression showed Child-Pugh group to be the only predictor for survival. CONCLUSIONS: Small intestinal bacterial overgrowth in cirrhotic patients is common and associated with systemic endotoxemia. The clinical relevance of this association remains to be defined.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Bacterial overgrowth in the upper gastrointestinal tract is associated with increased circulating lipopolysaccharide levels.
“In addition to alterations in bacterial composition, there is evidence for bacterial overgrowth in the upper gastrointestinal tract, which in turn is associated with increased circulating LPS levels 87.”
From The gut microbiome and liver cancer: mechanisms and clinical translation (2017) · cites this paper as [87]
Endotoxemia may occur as a consequence of small intestinal bacterial overgrowth.
“as a consequence of small intestinal bacterial overgrowth (SIBO),30,31”
From The Gut Microbiome and the Brain (2014) · cites this paper as [30]
Cites
Liu, Y., Zhou, Z., Chen, K.-L., Zhou, B., Yang, L., Yan, H., & Li, Y. (2012) · Hepatogastroenterology · doi:10.5754/hge12281 · Cited by 2,097 · see citing works
Parlesak, A., Schäfer, C., Schütz, T., Bode, J. C., & Bode, C. (2000) · Journal of Hepatology · doi:10.1016/s0168-8278(00)80242-1 · Cited by 647 · see citing works
Bode, C., Kugler, V., & Bode, J. C. (1987) · Journal of Hepatology · doi:10.1016/s0168-8278(87)80003-x · Cited by 529 · see citing works
Increased serum nitrite and nitrate levels in patients with cirrhosis: relationship to endotoxemia
Guarner, C., Soriano, G., Tomas, A., Bulbena, O., Novella, M. T., Balanzo, J., Vilardell, F., Mourelle, M., & Moncada, S. (1993) · Hepatology · doi:10.1002/hep.1840180520 · Cited by 489 · see citing works
Fukui, H., Brauner, B., Bode, J. C., & Bode, C. (1991) · Journal of Hepatology · doi:10.1016/0168-8278(91)90933-3 · Cited by 461 · see citing works
Lumsden, A. B., Henderson, M. J., & Kutner, M. H. (1988) · Hepatology · doi:10.1002/hep.1840080207 · Cited by 427 · see citing works
Endotoxin and Bacteria in Portal Blood
Jacob, A. I., Goldberg, P. K., Bloom, N. D., Degenshein, G. A., & Kozinn, P. J. (1977) · Gastroenterology · doi:10.1016/s0016-5085(77)80025-5 · Cited by 393 · see citing works
Leaky Gut in Alcoholic Cirrhosis: A Possible Mechanism for Alcohol-Induced Liver Damage
Keshavarzian, A., HOLMES, E. W., Patel, M., Iber, F. L., Fields, J. Z., & Pethkar, S. (1999) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.1999.00797.x · Cited by 381 · see citing works
TRIPLET PREGNANCY AFTER PULSATILE ADMINISTRATION OF GONADOTROPIN RELEASING HORMONE
Bogchelman, D. H., Lappöhn, R. E., & Janssens, J. (1982) · The Lancet · doi:10.1016/s0140-6736(82)91180-1 · Cited by 378 · see citing works
Lin, R.-S., Lee, F.-Y., Lee, S.-D., Tsai, Y.-T., Lin, H. C., Rei-Hwa, L., Wan-Ching, H., Cheng-Chun, H., Sun-Sang, W., & Kwang-Juei, L. (1995) · Journal of Hepatology · doi:10.1016/0168-8278(95)80424-2 · Cited by 355 · 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
The Role of Endotoxin in Liver Injury
Nolan, J. P. (1975) · Gastroenterology · doi:10.1016/s0016-5085(19)32333-9 · Cited by 283 · see citing works
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
Self-citationChang, 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
Attar, A., Flourié, B., Rambaud, J., Franchisseur, C., Ruszniewski, P. B., & Bouhnik, Y. (1999) · Gastroenterology · doi:10.1016/s0016-5085(99)70336-7 · Cited by 228 · see citing works
Runyon, B. A., Squier, S. U., & Borzio, M. (1994) · Journal of Hepatology · doi:10.1016/s0168-8278(94)80241-6 · Cited by 218 · see citing works
Intestinal Endotoxins As Mediators of Hepatic Injury—An Idea Whose Time Has Come Again
Nolan, J. P. (1989) · Hepatology · doi:10.1002/hep.1840100523 · Cited by 203 · see citing works
Prytz, H., Holst-Christensen, J., KORNER, B., & Liehr, H. (1976) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365521.1976.12097199 · Cited by 179 · see citing works
Effect of cisapride on intestinal bacterial overgrowth and bacterial translocation in cirrhosis
Pardo, A., Bartolí, R., Lorenzo-Zúñiga, V., Planas, R., Viñado, B., Riba, J., Cabré, E., Santos, J., Luque, T., Ausina, V., et al. (2000) · Hepatology · doi:10.1053/he.2000.5746 · Cited by 177 · see citing works
BREATH-HYDROGEN TEST FOR SMALL-INTESTINAL BACTERIAL COLONISATION
Metz, G. L., Drašar, B. S., Gassull, M. A., Jenkins, D. J. A., & Blendis, L. M. (1976) · The Lancet · doi:10.1016/s0140-6736(76)92779-3 · Cited by 161 · see citing works
Llovet, J. M., Bartolí, R., March, F., Planas, R., Viñado, B., Cabré, E., Arnal, J., Coll, P., Ausina, V., & Gassull, M. A. (1998) · Journal of Hepatology · doi:10.1016/0168-8278(88)80018-7 · Cited by 146 · see citing works
Endotoxemia, encephalopathy, and mortality in cirrhotic patients.
Bigatello, L. M., Broitman, S. A., Fattori, L., Di Paoli, M., Pontello, M. M., Bevilacqua, G., & Nespoli, A. (1987) · PubMed · Cited by 143 · 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
Prognostic Value of Plasma Endotoxin Levels in Patients with Cirrhosis
Chan, C. C., Hwang, S. J., Lee, F. Y., Wang, S. S., Chang, F. Y., Li, C. P., Chu, C. J., Lu, R. H., & Lee, S. D. (1997) · Scandinavian Journal of Gastroenterology · doi:10.3109/00365529709011206 · Cited by 113 · see citing works
Hanck, C., Rossol, S., BOCKER, U., TOKUS, M., & SINGER, M. V. (1998) · Alcohol and Alcoholism · doi:10.1093/alcalc/33.6.606 · Cited by 89 · see citing works
Yang, C. (1998) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365529850171549 · Cited by 83 · see citing works
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
Self-citationBode, C., Kolepke, R., Schäfer, K., & Bode, J. C. (1993) · PubMed · Cited by 79 · see citing works
Gastrointestinal dysfunction in liver disease and portal hypertension
Quiqley, E. M. M. (1996) · Digestive Diseases and Sciences · doi:10.1007/bf02282341 · Cited by 70 · see citing works
Rumessen, J. J., Gudmand-Höyer, E., Bachmann, E., & Justesen, T. (1985) · Scandinavian Journal of Gastroenterology · doi:10.3109/00365528509089288 · Cited by 68 · see citing works
Hiki, N., Berger, D., Prigl, C., Boelke, E., Wiedeck, H., Seidelmann, M., Staib, L., Kaminishi, M., Oohara, T., & Beger, H. G. (1998) · Infection and Immunity · doi:10.1128/iai.66.3.1135-1141.1998 · Cited by 63 · see citing works
Self-citationA syndrome of cirrhosis, achlorhydria, small intestinal bacterial overgrowth, and fat malabsorption.
Shindo, K., MACHIDA, M., Miyakawa, K., & Fukumura, M. (1993) · PubMed · Cited by 59 · see citing works
GERMFREE ANIMALS AND LIVER NECROSIS
Luckey, T. D., Reyniers, J. A., György, P., & Forbes, M. (1954) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1954.tb36472.x · Cited by 52 · see citing works
IN VIVO DETOXIFICATION OF ENDOTOXIN BY THE RETICULOENDOTHELIAL SYSTEM
Wiznitzer, T. L., Better, N., Rachlin, W., Atkins, N., Frank, E. D., & Fine, J. (1960) · The Journal of Experimental Medicine · doi:10.1084/jem.112.6.1157 · Cited by 49 · see citing works
Increased serum nitrite and nitrate levels in patients with cirrhosis: Relationship to endotoxemia
Guarner, C. (1993) · Hepatology · doi:10.1016/0270-9139(93)90470-8 · Cited by 48 · see citing works
Sex‐Related Liver Injury Due to Alcohol Involves Activation of Kupffer Cells by Endotoxin
Thurman, R. G. (1999) · Canadian Journal of Gastroenterology and Hepatology · doi:10.1155/2000/735262 · Cited by 45 · 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
Sulfonamide Drugs as Protective Agents Against Carbon Tetrachloride Poisoning.
Leach, B. E., & Forbes, J. C. (1941) · Experimental Biology and Medicine · doi:10.3181/00379727-48-13322p · Cited by 36 · see citing works
Berger, D., Bölke, E., Huegel, H., Seidelmann, M., Hannekum, A., & Beger, H. G. (1995) · Clinica Chimica Acta · doi:10.1016/0009-8981(95)06105-m · Cited by 33 · see citing works
Self-citationThe relationship between endotoxin and the phagocytic activity of the reticuloendothelial system.
Kuratsune, H., Koda, T., & Kurahori, T. (1983) · PubMed · Cited by 26 · see citing works
Comparison of three methods to obtain upper small bowel contents for culture.
León‐Barúa, R., Gilman, R. H., Rodríguez, C., Pineda-Bonilla, J. J., Yi, A., Maúrtua, D., & Sack, R. B. (1993) · PubMed · Cited by 24 · see citing works
Small bowel bacterial overgrowth: Epiphenomenon or bad actor in cirrhosis?
Grimm, I. S., & Shaheen, N. (1996) · Gastroenterology · doi:10.1053/gast.1996.v110.agast960955 · Cited by 6 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Changes of Intestinal Functions in Liver Cirrhosis
Fukui, H., & Wiest, R. (2016) · Inflammatory Intestinal Diseases · doi:10.1159/000444436 · Cited by 6,820 · see citing works
Alterations of the human gut microbiome in liver cirrhosis
Qin, N., Yang, F., Li, A., Prifti, E., Chen, Y., Shao, L., Guo, J., Le Chatelier, E., Yao, J., Wu, L., et al. (2014) · Nature · doi:10.1038/nature13568 · Cited by 2,177 · see citing works
Creely, S. J., McTernan, P. G., Kusminski, C. M., Fisher, F. M., Da Silva, N. F., Khanolkar, M., Evans, M., Harte, A. L., & Kumar, S. (2007) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00302.2006 · Cited by 1,043 · see citing works
Interactions Between the Intestinal Microbiome and Liver Diseases
Schnabl, B., & Brenner, D. A. (2014) · Gastroenterology · doi:10.1053/j.gastro.2014.01.020 · Cited by 971 · see citing works
Pathological bacterial translocation in liver cirrhosis
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
The gut–liver axis and gut microbiota in health and liver disease
Hsu, C. L., & Schnabl, B. (2023) · Nature Reviews Microbiology · doi:10.1038/s41579-023-00904-3 · Cited by 737 · see citing works
Bacterial translocation (BT) in cirrhosis†
Wiest, R., & Garcia‐Tsao, G. (2005) · Hepatology · doi:10.1002/hep.20632 · Cited by 677 · see citing works
The Gut Microbiome and the Brain
Galland, L. (2014) · Journal of Medicinal Food · doi:10.1089/jmf.2014.7000 · Cited by 648 · see citing works
The gut microbiome and liver cancer: mechanisms and clinical translation
Yu, L.-X., & Schwabe, R. F. (2017) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/nrgastro.2017.72 · Cited by 634 · see citing works
Bernardi, M., Moreau, R., Angeli, P., Schnabl, B., & Arroyo, V. (2015) · Journal of Hepatology · doi:10.1016/j.jhep.2015.07.004 · Cited by 633 · see citing works
Small intestinal bacterial overgrowth syndrome
Bures, J. (2010) · World Journal of Gastroenterology · doi:10.3748/wjg.v16.i24.2978 · Cited by 620 · see citing works
Bacterial Infections, Sepsis, and Multiorgan Failure in Cirrhosis
Tandon, P., & García–Tsao, G. (2008) · Seminars in Liver Disease · doi:10.1055/s-2008-1040319 · Cited by 549 · see citing works
Role of Insulin Resistance in MAFLD
Sakurai, Y., Kubota, N., Yamauchi, T., & Kadowaki, T. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22084156 · Cited by 448 · see citing works
Acute-on-chronic liver failure in cirrhosis
Arroyo, V., Moreau, R., Kamath, P. S., Jalan, R., Ginès, P., Nevens, F., Fernández, J., To, U. K., García–Tsao, G., & Schnabl, B. (2016) · Nature Reviews Disease Primers · doi:10.1038/nrdp.2016.41 · Cited by 442 · see citing works
Alterations in the gut microbiome and metabolism with coronary artery disease severity
Liu, H., Chen, X., Hu, X., Niu, H., Tian, R., Wang, H., Pang, H., Jiang, L., Qiu, B., Chen, X., et al. (2019) · Microbiome · doi:10.1186/s40168-019-0683-9 · Cited by 374 · see citing works
Sharma, B. C., Sharma, P., Lunia, M. K., Srivastava, S., Goyal, R., & Sarin, S. K. (2013) · American Journal of Gastroenterology · doi:10.1038/ajg.2013.219 · Cited by 343 · see citing works
Small intestinal bacterial overgrowth: a comprehensive review.
(2007) · PubMed Central · Cited by 321 · 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
The intestinal microbiota and chronic disorders of the gut
Dupont, A. W., & DuPont, H. L. (2011) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/nrgastro.2011.133 · Cited by 306 · see citing works
Gastric Juice: A Barrier Against Infectious Diseases
Martinsen, T. C., Bergh, K., & Waldum, H. L. (2005) · Basic & Clinical Pharmacology & Toxicology · doi:10.1111/j.1742-7843.2005.pto960202.x · Cited by 298 · see citing works
Chakaroun, R., Massier, L., & Kovacs, P. L. (2020) · Nutrients · doi:10.3390/nu12041082 · Cited by 297 · see citing works
Vallianou, N. G., Christodoulatos, G. S., Karampela, Ι., Tsilingiris, D., Magkos, F., Stratigou, T., Kounatidis, D. C., & Dalamaga, Μ. (2021) · Biomolecules · doi:10.3390/biom12010056 · Cited by 299 · see citing works
Microbiota and the gut-liver axis: Bacterial translocation, inflammation and infection in cirrhosis
Giannelli, V. (2014) · World Journal of Gastroenterology · doi:10.3748/wjg.v20.i45.16795 · Cited by 237 · see citing works
Gut–liver axis, cirrhosis and portal hypertension: the chicken and the egg
Arab, J. P., Martín‐Mateos, R., & Shah, V. H. (2017) · Hepatology International · doi:10.1007/s12072-017-9798-x · Cited by 229 · see citing works
Diabetes mellitus in patients with cirrhosis: clinical implications and management
Elkrief, L., Rautou, P., Sarin, S. K., Valla, D. C., Paradis, V., & Moreau, R. (2016) · Liver International · doi:10.1111/liv.13115 · Cited by 222 · 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
Gut Microbiota: The Conductor in the Orchestra of Immune–Neuroendocrine Communication
El Aidy, S., Dinan, T. G., & Cryan, J. F. (2015) · Clinical Therapeutics · doi:10.1016/j.clinthera.2015.03.002 · Cited by 215 · see citing works
Teltschik, Z., Wiest, R., Beisner, J., Nuding, S., Hofmann, C., Schöelmerich, J., Bevins, C. L., Stange, E. F., & Wehkamp, J. (2011) · Hepatology · doi:10.1002/hep.24789 · Cited by 196 · see citing works
Leaky gut and the liver: a role for bacterial translocation in nonalcoholic steatohepatitis.
Ilan, Y. (2012) · World Journal of Gastroenterology · doi:10.3748/wjg.v18.i21.2609 · Cited by 209 · see citing works
Gut-liver axis in liver cirrhosis: How to manage leaky gut and endotoxemia
Fukui, H. (2015) · World Journal of Hepatology · doi:10.4254/wjh.v7.i3.425 · Cited by 195 · see citing works
Microbiome-Mediated Effects of the Mediterranean Diet on Inflammation
Bailey, M. A., & Holscher, H. D. (2018) · Advances in Nutrition · doi:10.1093/advances/nmy013 · Cited by 187 · see citing works
Tan, C., Ling, Z., Huang, Y., Cao, Y.-D., Liu, Q., Cai, T., Yuan, H., Liu, C., Li, Y., & Ke-qian, X. (2015) · Pancreas · doi:10.1097/mpa.0000000000000355 · Cited by 184 · see citing works
Gut microbiota and probiotics in chronic liver diseases
Cesaro, C., Tiso, A., Del Prete, A., Cariello, R., Tuccillo, C., Cotticelli, G., del Vecchio Blanco, C., & Loguercio, C. (2011) · Digestive and Liver Disease · doi:10.1016/j.dld.2010.10.015 · Cited by 182 · see citing works
Microbiota-Immune Interaction in the Pathogenesis of Gut-Derived Infection
Wang, C., Li, Q., & Ren, J. (2019) · Frontiers in Immunology · doi:10.3389/fimmu.2019.01873 · Cited by 167 · see citing works
Altered Microbiome in Patients With Cirrhosis and Complications
Acharya, C., & Bajaj, J. S. (2018) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2018.08.008 · Cited by 161 · see citing works
Targeting the gut-liver-immune axis to treat cirrhosis
Tranah, T. H., Edwards, L. A., Schnabl, B., & Shawcross, D. L. (2020) · Gut · doi:10.1136/gutjnl-2020-320786 · Cited by 161 · see citing works
Role of Gut Dysbiosis in Liver Diseases: What Have We Learned So Far?
Fukui, H. (2019) · Diseases · doi:10.3390/diseases7040058 · Cited by 151 · see citing works
Risk factors and outcome of bacterial infections in cirrhosis
Bruns, T. (2014) · World Journal of Gastroenterology · doi:10.3748/wjg.v20.i10.2542 · Cited by 148 · see citing works
Refining the Ammonia Hypothesis
Tapper, E. B., Jiang, Z. G., & Patwardhan, V. R. (2015) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2015.03.003 · Cited by 148 · see citing works
Enteric Microbial Flora, Bacterial Overgrowth, and Short-Bowel Syndrome
DiBaise, J. K., Young, R. J., & Vanderhoof, J. A. (2006) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2005.10.020 · Cited by 170 · see citing works
Role of TLR9 in hepatic stellate cells and experimental liver fibrosis
Gäbele, E., Mühlbauer, M., Dorn, C., Weiß, T. S., Froh, M., Schnabl, B., Wiest, R., Schölmerich, J., Obermeier, F., & Hellerbrand, C. (2008) · Biochemical and Biophysical Research Communications · doi:10.1016/j.bbrc.2008.08.096 · Cited by 141 · see citing works
Ponziani, F. R., Zocco, M. A., Cerrito, L., Gasbarrini, A., & Pompili, M. (2018) · Expert Review of Gastroenterology & Hepatology · doi:10.1080/17474124.2018.1481747 · Cited by 139 · see citing works
Lata, J., Novotný, I., Příbramská, V., Juránková, J., Fric, P., Kroupa, R., & Stibůrek, O. (2007) · European Journal of Gastroenterology & Hepatology · doi:10.1097/meg.0b013e3282efa40e · Cited by 129 · see citing works
Wang, W., Xu, A.-L., Li, Z.-C., Li, Y., Xu, S.-F., Sang, H.-C., & Zhi, F. C. (2019) · Diabetes & Metabolism Journal · doi:10.4093/dmj.2019.0042 · Cited by 124 · see citing works
Microbial Translocation in Chronic Liver Diseases
Pinzone, M. R., Celesia, B. M., Rosa, M. D., Cacopardo, B. S., & Nunnari, G. (2012) · International Journal of Microbiology · doi:10.1155/2012/694629 · Cited by 119 · see citing works
Metagenomics of the Human Body
Nelson, K. E. (2010) · Springer eBooks · doi:10.1007/978-1-4419-7089-3 · Cited by 117 · see citing works
Li, Q., Wang, C., Tang, C. X., He, Q., Zhao, X., Li, N., & Li, J. (2015) · Critical Care · doi:10.1186/s13054-015-0738-7 · Cited by 118 · see citing works
Dultz, G., Piiper, A., Zeuzem, S., Kronenberger, B., & Waidmann, O. (2014) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.13061 · Cited by 116 · see citing works
Leaky Gut and Gut-Liver Axis in Liver Cirrhosis: Clinical Studies Update
Fukui, H. (2020) · Gut and Liver · doi:10.5009/gnl20032 · Cited by 115 · see citing works
Changes of gut bacteria and immune parameters in liver transplant recipients
Wu, Z., Ling, Z., Lu, H., Zuo, J., Sheng, J., Zheng, S., & Li, L. (2012) · Hepatobiliary & pancreatic diseases international · doi:10.1016/s1499-3872(11)60124-0 · Cited by 112 · see citing works
The intestinal flora and bacterial infection in cirrhosis
Riordan, S. M., & Williams, R. L. (2006) · Journal of Hepatology · doi:10.1016/j.jhep.2006.08.001 · Cited by 112 · see citing works
Kjærgaard, K., Mikkelsen, A. C. D., Wernberg, C. W., Grønkjær, L. L., Eriksen, P. L., Damholdt, M. F., Mookerjee, R. P., Vilstrup, H., Lauridsen, M. M., & Thomsen, K. L. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10040673 · 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
Infectious Complications of Acute and Chronic Liver Disease
Leber, B., Spindelboeck, W., & Stadlbauer, V. (2012) · Seminars in Respiratory and Critical Care Medicine · doi:10.1055/s-0032-1301737 · Cited by 103 · see citing works
Kang, S. H., Lee, Y. B., Lee, J., Nam, J. Y., Chang, Y. W., Cho, H., Yoo, J., Cho, Y. Y., Cho, E. J., Yu, S. J., et al. (2017) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.14275 · Cited by 100 · see citing works
Gut Microbiota and Complications of Liver Disease
Acharya, C., & Bajaj, J. S. (2017) · Gastroenterology Clinics of North America · doi:10.1016/j.gtc.2016.09.013 · Cited by 96 · see citing works
Small bowel bacterial overgrowth: Presentation, diagnosis, and treatment
Singh, V. V., & Toskes, P. P. (2004) · Current Treatment Options in Gastroenterology · doi:10.1007/s11938-004-0022-4 · Cited by 91 · see citing works
Gut : liver : brain axis: the microbial challenge in the hepatic encephalopathy
Mancini, A., Campagna, F., Amodio, P., & Tuohy, K. M. (2018) · Food & Function · doi:10.1039/c7fo01528c · Cited by 89 · see citing works
Jun, D. W., Kim, K. T., Lee, O. Y., Chae, J. D., Son, B. K., Kim, S. H., Jo, Y. J., & Park, Y. S. (2009) · Digestive Diseases and Sciences · doi:10.1007/s10620-009-0870-9 · Cited by 90 · see citing works
Bacterial translocation markers in liver cirrhosis
Alexopoulou, A. A. (2017) · Annals of Gastroenterology · doi:10.20524/aog.2017.0178 · Cited by 87 · see citing works
Fernández‐Rodríguez, C., Romero, J., Petros, T. J., Bradshaw, H. B., Gasalla-Herraiz, J., García, M. L. G., Lledó, J. L., Santander, C., Perez, M. T., Tomás, E., et al. (2004) · Liver International · doi:10.1111/j.1478-3231.2004.0945.x · Cited by 84 · see citing works
Bluemel, S., Williams, B., Knight, R. D., & Schnabl, B. (2016) · American Journal of Physiology-Gastrointestinal and Liver Physiology · doi:10.1152/ajpgi.00245.2016 · Cited by 83 · see citing works
Tsiaoussis, G. I. (2015) · World Journal of Hepatology · doi:10.4254/wjh.v7.i17.2058 · Cited by 82 · see citing works
Kwak, D. S., Jun, D. W., Seo, J. G., Chung, W., Park, S.-E., Lee, K. N., Saeed, W. K., Lee, H. L., Lee, O. Y., Yoon, B. C., et al. (2014) · European Journal of Gastroenterology & Hepatology · doi:10.1097/meg.0000000000000214 · Cited by 80 · see citing works
Mikkelsen, S. U., Allin, K. H., & Knop, F. K. (2016) · Diabetes Obesity and Metabolism · doi:10.1111/dom.12637 · Cited by 80 · see citing works
Small Intestine Bacterial Overgrowth and Environmental Enteropathy in Bangladeshi Children
Donowitz, J. R., Haque, R., Kirkpatrick, B. D., Alam, M., Lu, M., Kabir, M., Kakon, S. H., Islam, B. Z., Afreen, S., Musa, A., et al. (2016) · mBio · doi:10.1128/mbio.02102-15 · Cited by 79 · see citing works
Pathogenesis of hepatic encephalopathy: the tumour necrosis factor‐α theory
Odeh, M. (2007) · European Journal of Clinical Investigation · doi:10.1111/j.1365-2362.2007.01778.x · Cited by 78 · see citing works
Current concepts on the role of nitric oxide in portal hypertension
Hu, L. S. (2013) · World Journal of Gastroenterology · doi:10.3748/wjg.v19.i11.1707 · Cited by 77 · see citing works
Gut-liver axis: Recent concepts in pathophysiology in alcohol-associated liver disease
Raya Tonetti, F., Eguileor, A., Mrdjen, M., Pathak, V., Travers, J., Nagy, L. E., & Llorente, C. (2024) · Hepatology · doi:10.1097/hep.0000000000000924 · Cited by 78 · see citing works
Arab, J. P., Arrese, M. A., & Shah, V. H. (2019) · Hepatology Research · doi:10.1111/hepr.13473 · Cited by 72 · see citing works
The Influence of Small Intestinal Bacterial Overgrowth in Digestive and Extra-Intestinal Disorders
Losurdo, G., D’Abramo, F. S., Indellicati, G., Lillo, C., Ierardi, E., & Leo, A. D. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21103531 · Cited by 71 · see citing works
Small bowel bacterial overgrowth: Presentation, diagnosis, and treatment
Singh, V. V., & Toskes, P. P. (2003) · Current Gastroenterology Reports · doi:10.1007/s11894-003-0048-0 · Cited by 70 · see citing works
Spontaneous bacterial peritonitis: The clinical challenge of a leaky gut and a cirrhotic liver
Lutz, P. L. (2015) · World Journal of Hepatology · doi:10.4254/wjh.v7.i3.304 · Cited by 65 · see citing works
Quigley, E. M. M. (2007) · Gastroenterology Clinics of North America · doi:10.1016/j.gtc.2007.07.012 · Cited by 67 · see citing works
Gut Microbiota and Host Reaction in Liver Diseases
Fukui, H. (2015) · Microorganisms · doi:10.3390/microorganisms3040759 · Cited by 64 · see citing works
Bile acid homeostasis paradigm and its connotation with cholestatic liver diseases
Yang, T., Khan, G. J., Wu, Z., Wang, X., Zhang, L., & Jiang, Z. (2018) · Drug Discovery Today · doi:10.1016/j.drudis.2018.09.007 · Cited by 64 · see citing works
Gastrointestinal tract in liver disease: which organ is sick?
Norman, K., & Pirlich, M. (2008) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/mco.0b013e32830a70bc · Cited by 63 · see citing works
Martínez, J. E., Vargas-González, A., Pérez, T., Encı́o, I., Cabello-Olmo, M., & Barajas, M. (2021) · Nutrients · doi:10.3390/nu13092905 · Cited by 65 · see citing works
The gut microbiota: A new potential driving force in liver cirrhosis and hepatocellular carcinoma
Sanduzzi‐Zamparelli, M., Rocco, A., Compare, D., & Nardone, G. (2017) · United European Gastroenterology Journal · doi:10.1177/2050640617705576 · Cited by 60 · see citing works
Gundling, F., Schmidtler, F., Hapfelmeier, A., Schulte, B., Schmidt, T., Pehl, C., Schepp, W., & Seidl, H. (2011) · Liver International · doi:10.1111/j.1478-3231.2011.02577.x · Cited by 61 · see citing works
Probiotics and prebiotics — renaissance of a therapeutic principle
Fric, P. (2007) · Open Medicine · doi:10.2478/s11536-007-0031-5 · Cited by 60 · see citing works
Pediatric Non-Alcoholic Fatty Liver Disease: Nutritional Origins and Potential Molecular Mechanisms
Mandala, A., Janssen, R., Palle, S. K., Short, K., & Friedman, J. (2020) · Nutrients · doi:10.3390/nu12103166 · Cited by 51 · see citing works
Targeting Dysbiosis for the Treatment of Liver Disease
Anand, G. S., Zarrinpar, A., & Loomba, R. S. (2016) · Seminars in Liver Disease · doi:10.1055/s-0035-1571276 · Cited by 58 · see citing works
Massonnet, B., Delwail, A., Ayrault, J.-M., Chagneau-Derrode, C., Lecron, J., & Silvain, C. (2009) · Clinical & Experimental Immunology · doi:10.1111/j.1365-2249.2009.04004.x · Cited by 55 · see citing works
Remote Sensing Between Liver and Intestine: Importance of Microbial Metabolites
Fu, Z. D., & Cui, J. Y. (2017) · Current Pharmacology Reports · doi:10.1007/s40495-017-0087-0 · Cited by 54 · see citing works
Verbeke, L., Nevens, F., & Laleman, W. (2011) · Critical Care · doi:10.1186/cc10424 · Cited by 51 · see citing works
Ferguson, J., Dover, A. R., Chia, S., Cruden, N., Hayes, P. C., & Newby, D. E. (2005) · Gut · doi:10.1136/gut.2005.076562 · Cited by 51 · see citing works
Violi, F., Pignatelli, P., Castellani, V., Carnevale, R., & Cammisotto, V. (2022) · Blood Reviews · doi:10.1016/j.blre.2022.100998 · Cited by 52 · see citing works
Zhang, W., GU, Y.-R., Chen, Y., Deng, H. X., Chen, L., Chen, S., Zhang, G., & Gao, Z. (2010) · European Journal of Gastroenterology & Hepatology · doi:10.1097/meg.0b013e32833eb8b0 · Cited by 50 · see citing works
Pediatric small intestine bacterial overgrowth in low-income countries
Donowitz, J. R., & Petri, W. A. (2014) · Trends in Molecular Medicine · doi:10.1016/j.molmed.2014.11.001 · Cited by 49 · see citing works
An update on the pathogenesis and clinical management of cirrhosis with refractory ascites
Neong, S. F., Adebayo, D., & Wong, F. S.-H. (2018) · Expert Review of Gastroenterology & Hepatology · doi:10.1080/17474124.2018.1555469 · Cited by 49 · see citing works
Small bowel bacterial overgrowth in adults: A potential contributor to intestinal failure
Ziegler, T. R., & Cole, C. R. (2007) · Current Gastroenterology Reports · doi:10.1007/s11894-007-0060-x · Cited by 48 · see citing works
Gerritsen, J., Timmerman, H. M., Fuentes, S., van Minnen, L. P., Panneman, H. J., Konstantinov, S. R., Rombouts, F. M., Gooszen, H. G., Akkermans, L. M. A., Smidt, H., et al. (2011) · Applied and Environmental Microbiology · doi:10.1128/aem.05428-11 · Cited by 47 · see citing works
Critical Evaluation of Diagnosing Bacterial Overgrowth in the Proximal Small Intestine
Kerckhoffs, A. P. M., Visser, M. R., Samsom, M., van der Rest, M. E., de Vogel, J., Amerongen, W. C. M. H.-V., & Akkermans, L. M. A. (2008) · Journal of Clinical Gastroenterology · doi:10.1097/mcg.0b013e31818474d7 · Cited by 48 · see citing works
Anderson, W. B., Dixon, D. G., & Mayfield, C. I. (2007) · Journal of Water and Health · doi:10.2166/wh.2007.043 · Cited by 45 · see citing works
Pathophysiology and Management of Variceal Bleeding
Alqahtani, S. A., & Jang, S. N. (2021) · Drugs · doi:10.1007/s40265-021-01493-2 · Cited by 45 · see citing works
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
Vascular syndromes in liver cirrhosis
Shenoda, B. B., & Boselli, J. M. (2019) · Clinical Journal of Gastroenterology · doi:10.1007/s12328-019-00956-0 · Cited by 42 · see citing works
Gut microbiome and intestinal barrier failure – The “Achilles heel” in hepatology?
Benten, D., & Wiest, R. (2012) · Journal of Hepatology · doi:10.1016/j.jhep.2012.03.003 · Cited by 41 · see citing works
Spontaneous bacterial peritonitis: from pathophysiology to prevention
Bernardi, M. (2010) · Internal and Emergency Medicine · doi:10.1007/s11739-010-0446-x · Cited by 40 · see citing works
- Authors
- Bauer, T. M., Schwacha, H., Steinbruckner, B., Brinkmann, F. E., Ditzen, A. K., Aponte, J. J., Pelz, K., Berger, D., Kist, M., & Blum, H. E.
- Affiliations
- University of Freiburg (DE)
- University Medical Center Freiburg (DE)
- Hospital Clínic de Barcelona (ES)
- University Hospital Ulm (DE)
- Venue
- The American Journal of Gastroenterology
- Published
- 2002-09
- Volume
- 97
- Issue
- 9
- Pages
- 2364-2370
- ISSN
- 0002-9270 (ISSN-L)
- 1572-0241
- OpenAlex
- W1987665619
- Cited by
- 211
- References
- 43
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 7 · 2023: 13 · 2022: 6 · 2021: 18 · 2020: 12 · 2019: 9 · 2018: 14 · 2017: 13 · 2016: 16 · 2015: 14 · 2014: 12 · 2013: 5 · 2012: 8
- FWCI
- 2.33
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- FreiDok plus (Universitätsbibliothek Freiburg) (submittedVersion)
- 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, endotoxin, acid-suppressive therapy, Child-Pugh score, survival, chronic liver disease
- MeSH terms
- Adult, Aged, Female, Follow-Up Studies, Humans, Jejunum, Liver Cirrhosis, Male, Middle Aged, Predictive Value of Tests, Severity of Illness Index, Time Factors, Colony Count, Microbial, Survival Rate, Endotoxemia
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review