Saravana Ruban Gurusamy1,2, Ayesha Shah1,2, Nicholas J Talley3, Natasha Koloski1,2,3, Michael P Jones4, Marjorie M Walker3, Mark Morrison1,5, Gerald Holtmann1,2. 1. Faculty of Medicine, Faculty of Health and Behavioral Sciences, The University of Queensland, Brisbane, Australia. 2. Princess Alexandra Hospital, Department of Gastroenterology and Hepatology, Brisbane, Queensland, Australia. 3. Faculty of Health and Medicine, The University of Newcastle, Newcastle, Australia. 4. Macquarie University, Department of Psychology, Sydney, NSW, Australia. 5. University of Queensland, Diamantina Institute, QLD, Australia.
Abstract
INTRODUCTION: This systematic review and meta-analysis aimed to determine the role of small intestinal bacterial overgrowth (SIBO) in patients with functional dyspepsia (FD). METHODS: Electronic databases were searched until July 2020 for studies reporting prevalence of SIBO in FD. The prevalence rates, odds ratio, and 95% confidence intervals (CIs) of SIBO in FD and controls were calculated. RESULTS: Seven studies with 263 patients with FD and 84 controls were identified. The odds for SIBO in patients with FD were significantly higher as compared to that in controls (odds ratio = 4.3, 95% CI, 1.1-17.5, 4 studies, 234 participants); however, there was moderate heterogeneity in this analysis. Including high-quality, case-control studies (all using glucose breath tests [GBTs]), the risk of SIBO in patients with FD as compared to controls was 2.8 higher (95% CI 0.8-10.0, 3 studies, 200 participants) with minimal heterogeneity in this analysis. Using the lactulose breath test, SIBO prevalence in FD was significantly higher (53.4%, 95% CI 33.9-71.9, 3 studies, 110 participants) as compared to that with GBT (17.2%, 95% CI 8.6-31.6, 4 studies, 153 participants). Substantial heterogeneity was found in studies using the lactulose breath test but not in studies using GBT. There was no significant difference in SIBO prevalence in patients with FD according to FD subtype. DISCUSSION: This meta-analysis suggests a link between FD and SIBO. The quality of evidence is low and can be largely attributed to the type of breath test for SIBO diagnosis and clinical heterogeneity. More appropriately designed studies are required to confirm the link between SIBO and FD.
INTRODUCTION: This systematic review and meta-analysis aimed to determine the role of small intestinal bacterial overgrowth (SIBO) in patients with functional dyspepsia (FD). METHODS: Electronic databases were searched until July 2020 for studies reporting prevalence of SIBO in FD. The prevalence rates, odds ratio, and 95% confidence intervals (CIs) of SIBO in FD and controls were calculated. RESULTS: Seven studies with 263 patients with FD and 84 controls were identified. The odds for SIBO in patients with FD were significantly higher as compared to that in controls (odds ratio = 4.3, 95% CI, 1.1-17.5, 4 studies, 234 participants); however, there was moderate heterogeneity in this analysis. Including high-quality, case-control studies (all using glucose breath tests [GBTs]), the risk of SIBO in patients with FD as compared to controls was 2.8 higher (95% CI 0.8-10.0, 3 studies, 200 participants) with minimal heterogeneity in this analysis. Using the lactulose breath test, SIBO prevalence in FD was significantly higher (53.4%, 95% CI 33.9-71.9, 3 studies, 110 participants) as compared to that with GBT (17.2%, 95% CI 8.6-31.6, 4 studies, 153 participants). Substantial heterogeneity was found in studies using the lactulose breath test but not in studies using GBT. There was no significant difference in SIBO prevalence in patients with FD according to FD subtype. DISCUSSION: This meta-analysis suggests a link between FD and SIBO. The quality of evidence is low and can be largely attributed to the type of breath test for SIBO diagnosis and clinical heterogeneity. More appropriately designed studies are required to confirm the link between SIBO and FD.
Authors: Anupam Rej; Michael D E Potter; Nicholas J Talley; Ayesha Shah; Gerald Holtmann; David Surendran Sanders Journal: Am J Gastroenterol Date: 2022-04-08 Impact factor: 12.045
Authors: Uday C Ghoshal; Sanjeev Sachdeva; Ujjala Ghoshal; Asha Misra; Amarender Singh Puri; Nitesh Pratap; Ayesha Shah; M Masudur Rahman; Kok Ann Gwee; Victoria P Y Tan; Tahmeed Ahmed; Yeong Yeh Lee; B S Ramakrishna; Rupjyoti Talukdar; S V Rana; Saroj K Sinha; Minhu Chen; Nayoung Kim; Gerald Holtmann Journal: Indian J Gastroenterol Date: 2022-10-10