Received: NovemAccepted: FebruPublished: February 25, 2022Ĭopyright: © 2022 Yokoyama et al. PLoS ONE 17(2):Įditor: Tatsuo Kanda, Nihon University School of Medicine, JAPAN (2022) Hydrogen-producing small intestinal bacterial overgrowth is associated with hepatic encephalopathy and liver function. Therefore, the diagnosis of SIBO, including the classification as H-SIBO and M-SIBO, might help to determine the choice of treatment for HE.Ĭitation: Yokoyama K, Sakamaki A, Takahashi K, Naruse T, Sato C, Kawata Y, et al. In conclusion, H-SIBO, but not M-SIBO, is significantly associated with liver function, and rifaximin might be more effective for covert HE with H-SIBO. 20% patients with M-SIBO and 67% patients with H-SIBO showed an improvement of the breath test. In addition, we evaluated the therapeutic response on SIBO of rifaximin in eight covert HE patients. Furthermore, H-SIBO was significantly associated with covert HE in chi-square test (50.0% vs. Reclassification into H-SIBO (16 cases) and others (91 cases) was performed, and the Child-Pugh score was only derived in the multivariate logistic analysis (P = 0.028, odds ratio 1.39, 95% confidence interval 1.04–1.85). There were no significant differences between the SIBO positive and SIBO negative groups. The study cohort included 81 males with a median age of 70 (40–86) years, and SIBO was detected in 31 cases (29.0%). Breath measurements of hydrogen and methane concentrations were performed for the diagnosis of SIBO. This is a prospective cohort study of 107 cases. We investigated the relationship between SIBO and LC, and the difference between hydrogen-producing and methane-producing SIBO (H-SIBO and M-SIBO, respectively). Small intestinal bacterial overgrowth (SIBO) is significantly associated with LC and its complications, including HE. SIBO usually occurs as a result of these underlying conditions.Overt hepatic encephalopathy (HE) is one of the complications of liver cirrhosis (LC), which negatively affects the prognosis and quality of life of patients. It is recommended that you follow a low FODMAP diet, which limits carbohydrate intake in foods such as wheat, legumes, milk, yoghurt, fruits, honey and anything containing added sugars.Īntibiotics can help to stabilise the gut bacteria by reducing the number of intestinal bacteria.Īny pre-existing medical conditions, such as celiac disease or diabetes, should also be treated. SIBO is treated with antibiotic therapy and dietary changes. If these results are unclear, you might need blood and/or a urine test for laboratory analysis. A gastroenterologist will ask about your symptoms and make a medical examination by probing the abdomen to check for bloating and flatulence.Ī breath test is required to measure the concentration of hydrogen and methane in your breath, which informs the doctor about the severity and location of the SIBO in your gut. SIBO can be difficult to diagnose because it causes a wide range of symptoms. Other risk factors may include old age, being female, previous bowel surgery, overuse of antibiotics and drinking alcohol. People with medical conditions such as Crohn's disease, celiac disease, HIV, diabetes, IBS and fibromyalgia are also at risk of developing SIBO. As well as low levels of stomach acid, physical abnormalities of the small intestine and a weakened immune system. The abnormally slow movement of the digestive system is a factor for causing SIBO. Diagnosis of irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD). This can lead to symptoms such as bloating, flatulence and abdominal pain. If these 'healthy' bacteria begin to colonise in the small intestine, SIBO occurs. Most of the gut bacteria are supposed to be found in the large intestine and colon where they help to break down food, absorb vitamins and eliminate waste. Small intestinal bacterial overgrowth (SIBO) is a condition that affects the small intestine as a result of bacteria that normally grows in the gut (microbiome) becoming unbalanced and overgrows in the small intestine. What is small intestinal bacterial overgrowth (SIBO)?
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