Association Between Small Intestinal Bacterial Overgrowth And Severity Of Illness In Cirrhotic Patients

BackgroundIn cirrhotic patients,slow intestinal peristalsis,bile acid secretion,intestinal ischemia edema,increased permeability of the intestinal mucosa and intestinal immune dysfunction and other factors could provide the conditions for the propagation of bacteria,leading to small intestinal bacterial overgrowth(SIBO),while SIBO could be further aggravate liver damage.In this study,look forward that through retrospective cohort study of severity of cirrhosis with SIBO could oversee and intervene the patients in cirrhosis with SIBO,and ultimately slow the progression of cirrhosis and improve survival.PurposeInvestigate the relationship between small intestinal bacterial overgrowth(SIBO)and the severity of liver cirrhosis,the correlation of small intestinal bacterial growth,bilirubin,serum albumin,globulin and procalcitonin.Methods47 patients with cirrhosis were selected as observation group,and 15 healthy volunteers were selected as control group.All subjects were prospectively analysed by lactulose hydrogen breath test with the LHBT.A basal breath hydrogen >20ppm or a rise by312 ppm as SIBO positive test.Hydrogen breath gross were also measured in all subjects who exhaled gas within 90 minutes(LHBT set-value).Bilirubin,plasma albumin,globulin and serum procalcitonin were measured in all subjects.The gastrointestinal symptom(abdominal pain,bloating,Loss of appetite,constipation)of patients were evaluated by a guidance for clinical rational.ResultsIn 47 patients with liver cirrhosis,22 patients(46.8%)were SIBO positive.While in15 healthy persons in control group,only 1 case(6.6%,p<0.01)was SIBO positive;the LHBT level in patients with cirrhosis was(157.81±98.32)ppm,significantly higher than in the control group[(38.87±16.05)ppm,p<0.01],serum bilirubin levels were(93.31±55.15)?mol/L,significantly higher than that in the control group[(14.78±8.12)?mol/L,p<0.01],plasma albumin were(31.74±10.37)g/L,significantly lower than that in the control group[(43.90±7.63)g/L,p<0.01],globulin were(39.09±5.07)g/L,higher than that in the control group[(35.94±2.31)g/L,p > 0.05],procalcitonin were(0.10±0.07)ng/ml,significantly higher than that in the control group[(0.03±0.01)ng/ml,p < 0.01];plasma procalcitonin,bilirubin,globulin and albumin were respectively correlated to SIBO(r=0.895,p < 0.005;r=0.907,p < 0.005;r=0.755,p < 0.005;r=-0.810,p < 0.005).Conclusions Small intestinal bacterial overgrowth was prevalent in patients with liver cirrhosis.The cirrhotic patients with SIBO were more easily bloating and Loss of appetite.Conclusions:Small intestinal bacterial overgrowth was prevalent in cirrhotics.Its frequency increased with increase in severity of cirrhotics.The cirrhotic patients with SIBO were more easily bloating and Loss of appetite.Procalcitonin,bilirubin and plasma albumin were positively correlated with small intestinal bacterial growth.Globulin was negatively correlated with small intestinal bacterial growth.