Small Intestinal Bacterial Overgrowth among Patients with Cirrhosis

Abstract

Introduction: Acute chronic liver failure, spontaneous bacterial peritonitis, hepatic encephalopathy, and hepatorenal syndrome are a few of the grave complications of liver cirrhosis that may result in death. For years, small-intestinal bacterial overgrowth (SIBO) has been considered a predisposing factor for these complications in cirrhotic patients. However, data regarding SIBO in cirrhosis patients remain less focused in our country. Therefore, the study was designed to evaluate the risk of SIBO in patients with liver cirrhosis attending a tertiary care hospital, in Bangladesh. The aim of the study was to find out the association of small intestinal bacterial overgrowth (SIBO) with cirrhosis. Methods: This case-control study was carried out in the departments of Gastroenterology and Department of Hepatology, Dhaka medical college hospital during the period from September 2018 to October 2019 with a total of 136 patients equally divided into case and control groups. The case group consisted of patients with cirrhosis, while the control group comprised of healthy age-matched volunteers. Result: Among SIBO positive cases and control most common age group was 41-50 years of age. The majority were males observed in both the case (83.3%) and the control (66.7%) groups. The risk of SIBO was more in the cirrhotic patient as the odds ratio was > 1(OR= 7.8) with 95% CI 2.18-27.96. Overall frequency of SIBO was more among patients with higher CTP score {CTP-B (72.2%), CTP-C (27.8%)} with a p-value <0.05. Conclusion: Cirrhosis is associated with small intestinal bacterial overgrowth (SIBO). The frequency of SIBO also increases in cirrhotic patients with higher CTP scores.