The University of Queensland, Faculty of Medicine and Faculty of Health and Behavioural Sciences, Brisbane, QLD, Australia.
Department of Gastroenterology & Hepatology, Princess Alexandra Hospital, Brisbane, QLD, Australia.
Aliment Pharmacol Ther. 2019 Mar;49(6):624-635. doi: 10.1111/apt.15133. Epub 2019 Feb 8.
Current data on small intestinal bacterial overgrowth (SIBO) in patients with inflammatory bowel diseases (IBD) are controversial.
To conduct a systematic review and meta-analysis to determine the prevalence of SIBO in patients with ulcerative colitis (UC) and Crohn's disease (CD).
Electronic databases were searched up to May 2018 for studies reporting prevalence of SIBO in IBD patients. The prevalence rate of SIBO among IBD patients and the odds ratio (OR) and 95% CI of SIBO in IBD patients compared with controls were calculated.
The final dataset included 11 studies (1175 adult patients with IBD and 407 controls), all utilising breath test for diagnosis of SIBO. The proportion of SIBO in IBD patients was 22.3% (95% CI 19.92-24.68). The OR for SIBO in IBD patients was 9.51 (95% CI 3.39-26.68) compared to non-IBD controls, and high in both CD (OR = 10.86; 95% CI 2.76-42.69) and UC (OR = 7.96; 95% CI 1.66-38.35). In patients with CD, subgroup analysis showed the presence of fibrostenosing disease (OR = 7.47; 95% CI 2.51-22.20) and prior bowel surgery (OR = 2.38; 95% CI 1.65-3.44), especially resection of the ileocecal valve, increased the odds of SIBO. Individual studies suggest that combined small and large bowel disease but not disease activity may be associated with SIBO.
Overall, there is a substantial increase in the prevalence of SIBO in IBD patients compared to controls. Prior surgery and the presence of fibrostenosing disease are risk factors for SIBO in IBD.
目前关于炎症性肠病（IBD）患者小肠细菌过度生长（SIBO）的数据存在争议。
进行系统评价和荟萃分析，以确定溃疡性结肠炎（UC）和克罗恩病（CD）患者中 SIBO 的患病率。
检索电子数据库，截至 2018 年 5 月，以获取报告 IBD 患者 SIBO 患病率的研究。计算 IBD 患者中 SIBO 的患病率，以及与对照组相比 IBD 患者 SIBO 的比值比（OR）和 95%置信区间（CI）。
最终数据集包括 11 项研究（1175 例成人 IBD 患者和 407 例对照），均采用呼吸试验诊断 SIBO。IBD 患者中 SIBO 的比例为 22.3%（95%CI 19.92-24.68）。与非 IBD 对照组相比，IBD 患者的 SIBO 的 OR 为 9.51（95%CI 3.39-26.68），在 CD（OR=10.86；95%CI 2.76-42.69）和 UC（OR=7.96；95%CI 1.66-38.35）中均较高。在 CD 患者中，亚组分析显示纤维狭窄性疾病（OR=7.47；95%CI 2.51-22.20）和既往肠道手术（OR=2.38；95%CI 1.65-3.44）的存在增加了 SIBO 的可能性，特别是回盲瓣切除术。个别研究表明，小肠和大肠疾病的联合但非疾病活动可能与 SIBO 相关。
总体而言，与对照组相比，IBD 患者 SIBO 的患病率显著增加。既往手术和纤维狭窄性疾病是 IBD 患者 SIBO 的危险因素。
