Small Intestinal Bacterial Overgrowth in Patients With Severe Alcoholic Hepatitis: Frequency and Predictors.

BACKGROUND AND AIMS

Small intestinal bacterial overgrowth (SIBO) is a gut microbiota-related disorder characterized by excessive bacterial density and/or abnormal microbiota composition in the small intestine. We aimed to evaluate the frequency of SIBO in patients with severe alcoholic hepatitis (SAH) and to identify independent predictors.

METHODS

We included 60 consecutive patients with SAH and 30 healthy controls (HC). After an overnight fast, SIBO was evaluated using the glucose hydrogen breath test (GHBT) with 100 g of glucose. A sustained increase in breath hydrogen or methane levels > 12 parts per million (ppm) above the basal level was considered diagnostic for SIBO.

RESULTS

SIBO was more frequent in patients with SAH than HC (15/60 (25.0%) vs. 1/30 (3.3%), p = 0.017). In the univariate analysis, globulin levels, total protein levels, and predominant methane producer status significantly differed between patients with and without SIBO. In the multivariate analysis, the predominant methane producer status increased the risk of SIBO by 17.44 times (adjusted odds ratio: 17.44 (95% CI (1.9-154.04)), p = 0.001).

CONCLUSIONS

This study showed that SIBO is a more common finding in patients with SAH than in HC. The predominant methane producer status independently predicted the SIBO in these patients.