Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No.3 East Qingchun Road, Hangzhou, 310016, Zhejiang, China.
Division of Gastroenterology, Loma Linda University Medical Center, Loma Linda, USA.
J Gastroenterol. 2018 Jul;53(7):807-818. doi: 10.1007/s00535-018-1476-9. Epub 2018 May 14.
The reported prevalence of small intestinal bacterial overgrowth (SIBO) among individuals with irritable bowel syndrome (IBS) is highly variable. The aim of the study is to estimate the prevalence and identify predictors of SIBO in IBS.
PubMed, Cochrane Library, and EMBASE through July 2017 were searched to identify studies evaluating the prevalence of SIBO in IBS. The pooled prevalence of SIBO among individuals with IBS and the pooled odds ratio (OR) of SIBO among those with IBS compared with healthy controls were calculated. Predictors of SIBO among IBS patients were also evaluated.
Fifty studies (8398 IBS, 1432 controls) met the inclusion criteria. Overall pooled prevalence of SIBO in IBS was 38% (95% CI 32-44) and was higher among individuals with IBS (OR 4.7, 95% CI 3.1-7.2) compared with controls. The pooled prevalence of SIBO in IBS was higher in studies diagnosed by breath tests (40%, 95% CI 33-46) compared with cultures (19%, 95% CI 8-30). Among those with IBS, female gender (OR 1.5, 95% CI 1.0-2.1), older age (standard mean difference 3.1 years, 95% CI 0.9-5.4), and IBS-diarrhea (OR 1.7, 95% CI 1.3-2.3) compared with other IBS subtypes increased the odds of SIBO; proton pump inhibitor (PPI) use (OR 1.1, 95% CI 0.7-1.7) was not associated with SIBO.
More than one-third of IBS patients tested positive for SIBO, and the odds of SIBO in IBS were increased by nearly fivefold. The prevalence of SIBO varied according to the diagnostic modality performed. Female gender, older age, and IBS-diarrhea, but not PPI use, were associated with SIBO among individuals with IBS.
在肠易激综合征（IBS）患者中，小肠细菌过度生长（SIBO）的报道患病率差异很大。本研究旨在评估 IBS 患者中 SIBO 的患病率，并确定 SIBO 的预测因素。
通过检索 PubMed、Cochrane 图书馆和 EMBASE，检索评估 IBS 患者 SIBO 患病率的研究，截至 2017 年 7 月。计算 IBS 患者中 SIBO 的总体患病率，以及与健康对照组相比 IBS 患者中 SIBO 的合并比值比（OR）。还评估了 IBS 患者中 SIBO 的预测因素。
符合纳入标准的 50 项研究（8398 例 IBS、1432 例对照）。IBS 患者中 SIBO 的总体患病率为 38%（95%CI 32-44），高于对照组（OR 4.7，95%CI 3.1-7.2）。通过呼吸试验诊断的 IBS 患者中 SIBO 的患病率高于培养（40%，95%CI 33-46）。在 IBS 患者中，女性（OR 1.5，95%CI 1.0-2.1）、年龄较大（标准均数差 3.1 岁，95%CI 0.9-5.4）和 IBS-腹泻（OR 1.7，95%CI 1.3-2.3）与其他 IBS 亚型相比，SIBO 的几率增加；质子泵抑制剂（PPI）的使用（OR 1.1，95%CI 0.7-1.7）与 SIBO 无关。
超过三分之一的 IBS 患者 SIBO 检测呈阳性，IBS 患者发生 SIBO 的几率增加近五倍。SIBO 的患病率因所进行的诊断方式而异。在 IBS 患者中，女性、年龄较大和 IBS-腹泻与 SIBO 相关，而 PPI 的使用则无关。
