Cited by 212Liver Disease and TransplantationGut microbiota and healthGastrointestinal motility and disorders

Small intestinal bacterial overgrowth in human cirrhosis is associated with systemic endotoxemia

Bauer, Tilman M., Schwacha, Henning, Steinbruckner, Bernhard, Brinkmann, Folke E., Ditzen, Anette K., Aponte, John J., Pelz, Klaus, Berger, Dieter +2 more·2002·The American Journal of Gastroenterology

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.

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Crossref · 10.1111/j.1572-0241.2002.05791.x

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  • 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.”
  • 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]

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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

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