Prevalence and predictors of small intestinal bacterial overgrowth in inflammatory bowel disease: a meta-analysis

BackgroundSmall intestinal bacterial overgrowth (SIBO) has been reported to be very common among individuals with inflammatory bowel disease (IBD), and the prevalence of SIBO is highly variable. We conducted this study to calculate the prevalence and identify predictors of SIBO in IBD.MethodsPubMed,...

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Main Authors: Xin Feng, Jie Hu, Xin Zhang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2024.1490506/full
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author Xin Feng
Jie Hu
Xin Zhang
author_facet Xin Feng
Jie Hu
Xin Zhang
author_sort Xin Feng
collection DOAJ
description BackgroundSmall intestinal bacterial overgrowth (SIBO) has been reported to be very common among individuals with inflammatory bowel disease (IBD), and the prevalence of SIBO is highly variable. We conducted this study to calculate the prevalence and identify predictors of SIBO in IBD.MethodsPubMed, Cochrane Library, and EMBASE from inception to March 2024 were searched for studies evaluating the prevalence of SIBO in IBD. We calculated the pooled prevalence of SIBO among IBD patients and the odds ratio (OR) of SIBO in IBD compared with healthy controls. Besides, we also evaluated predictors of SIBO in IBD patients.ResultsTwenty-nine studies (3,250 IBD, 708 controls) were included in our study. The pooled prevalence of SIBO in IBD was 31.0% (95% CI 25.2–37.1), and the prevalence of SIBO was higher in IBD compared with healthy controls (OR 5.25, 95% CI 2.96–9.32). The pooled prevalence of SIBO was higher among CD patients (32.2, 95% CI 25.9–38.8) compared with UC patients (27.8, 95% CI 18.5–38.1). The odds of lower BMI (mean difference = −1.04; 95% CI −1.86 to −0.23), bloating (OR = 3.02, 95% CI 1.22–7.5), flatulence (OR = 4.70, 95% CI 1.44–15.35), history of abdominal surgery (OR = 2.05, 95% CI 1.35–3.11), and stricturing/penetrating disease behavior (OR = 3.51, 95% CI 1.67–7.40) increased significantly in IBD patients with SIBO compared to those without SIBO. Antibiotic treatment may be effective for SIBO in IBD patients.ConclusionNearly one-third of IBD patients present with SIBO positive, and the odds of SIBO in IBD was increased by 5.25-fold compared with healthy controls. Lower BMI, bloating, flatulence, history of abdominal surgery, and stricturing/penetrating disease behavior were predictors of SIBO in IBD patients.
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spelling doaj-art-e27d8690ec0b468b8dc69346ca0de79d2025-01-21T15:18:55ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-01-011110.3389/fmed.2024.14905061490506Prevalence and predictors of small intestinal bacterial overgrowth in inflammatory bowel disease: a meta-analysisXin Feng0Jie Hu1Xin Zhang2Department of Gastroenterology, The People’s Hospital of Yubei District of Chongqing City, Chongqing, ChinaDepartment of Ultrasound, The People’s Hospital of Yubei District of Chongqing City, Chongqing, ChinaDepartment of Gastroenterology, The People’s Hospital of Yubei District of Chongqing City, Chongqing, ChinaBackgroundSmall intestinal bacterial overgrowth (SIBO) has been reported to be very common among individuals with inflammatory bowel disease (IBD), and the prevalence of SIBO is highly variable. We conducted this study to calculate the prevalence and identify predictors of SIBO in IBD.MethodsPubMed, Cochrane Library, and EMBASE from inception to March 2024 were searched for studies evaluating the prevalence of SIBO in IBD. We calculated the pooled prevalence of SIBO among IBD patients and the odds ratio (OR) of SIBO in IBD compared with healthy controls. Besides, we also evaluated predictors of SIBO in IBD patients.ResultsTwenty-nine studies (3,250 IBD, 708 controls) were included in our study. The pooled prevalence of SIBO in IBD was 31.0% (95% CI 25.2–37.1), and the prevalence of SIBO was higher in IBD compared with healthy controls (OR 5.25, 95% CI 2.96–9.32). The pooled prevalence of SIBO was higher among CD patients (32.2, 95% CI 25.9–38.8) compared with UC patients (27.8, 95% CI 18.5–38.1). The odds of lower BMI (mean difference = −1.04; 95% CI −1.86 to −0.23), bloating (OR = 3.02, 95% CI 1.22–7.5), flatulence (OR = 4.70, 95% CI 1.44–15.35), history of abdominal surgery (OR = 2.05, 95% CI 1.35–3.11), and stricturing/penetrating disease behavior (OR = 3.51, 95% CI 1.67–7.40) increased significantly in IBD patients with SIBO compared to those without SIBO. Antibiotic treatment may be effective for SIBO in IBD patients.ConclusionNearly one-third of IBD patients present with SIBO positive, and the odds of SIBO in IBD was increased by 5.25-fold compared with healthy controls. Lower BMI, bloating, flatulence, history of abdominal surgery, and stricturing/penetrating disease behavior were predictors of SIBO in IBD patients.https://www.frontiersin.org/articles/10.3389/fmed.2024.1490506/fullsmall intestinal bacterial overgrowthinflammatory bowel diseasemeta-analysisulcerative colitisCrohn’s disease
spellingShingle Xin Feng
Jie Hu
Xin Zhang
Prevalence and predictors of small intestinal bacterial overgrowth in inflammatory bowel disease: a meta-analysis
Frontiers in Medicine
small intestinal bacterial overgrowth
inflammatory bowel disease
meta-analysis
ulcerative colitis
Crohn’s disease
title Prevalence and predictors of small intestinal bacterial overgrowth in inflammatory bowel disease: a meta-analysis
title_full Prevalence and predictors of small intestinal bacterial overgrowth in inflammatory bowel disease: a meta-analysis
title_fullStr Prevalence and predictors of small intestinal bacterial overgrowth in inflammatory bowel disease: a meta-analysis
title_full_unstemmed Prevalence and predictors of small intestinal bacterial overgrowth in inflammatory bowel disease: a meta-analysis
title_short Prevalence and predictors of small intestinal bacterial overgrowth in inflammatory bowel disease: a meta-analysis
title_sort prevalence and predictors of small intestinal bacterial overgrowth in inflammatory bowel disease a meta analysis
topic small intestinal bacterial overgrowth
inflammatory bowel disease
meta-analysis
ulcerative colitis
Crohn’s disease
url https://www.frontiersin.org/articles/10.3389/fmed.2024.1490506/full
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AT jiehu prevalenceandpredictorsofsmallintestinalbacterialovergrowthininflammatoryboweldiseaseametaanalysis
AT xinzhang prevalenceandpredictorsofsmallintestinalbacterialovergrowthininflammatoryboweldiseaseametaanalysis