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Journal of Gastroenterology

, Volume 53, Issue 7, pp 807–818 | Cite as

Prevalence and predictors of small intestinal bacterial overgrowth in irritable bowel syndrome: a systematic review and meta-analysis

  • Binrui Chen
  • John Jae-Woo Kim
  • Yawen Zhang
  • Lijun Du
  • Ning Dai
Review
  • 481 Downloads

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

Keywords

Small intestinal bacterial overgrowth Irritable bowel syndrome Culture Breath test 

Notes

Acknowledgements

This work was supported by the National Natural Science Foundation of China (NSFC 81670487).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

535_2018_1476_MOESM1_ESM.docx (268 kb)
Supplementary material 1 (DOCX 268 kb)

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Copyright information

© Japanese Society of Gastroenterology 2018

Authors and Affiliations

  1. 1.Department of Gastroenterology, Sir Run Run Shaw Hospital, School of MedicineZhejiang UniversityHangzhouChina
  2. 2.Division of GastroenterologyLoma Linda University Medical CenterLoma LindaUSA

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