SIBO Linked With Relapse of Quiescent Crohn Disease

Small intestinal bacterial overgrowth (SIBO) appears to be an independent indicator of clinical relapse in patients with quiescent Crohn disease, according to a study published online in the Annals of Translational Medicine.

“Alterations in the gastrointestinal microbiome occur in patients with Crohn’s disease. Numerous studies have suggested a link between SIBO and Crohn’s disease, but the significance of SIBO in diagnosing quiescent Crohn’s disease has not been extensively researched,” researchers wrote. “In this study, we explored whether SIBO is associated with subsequent clinical relapse of Crohn’s disease.”

The retrospective observational cohort study consisted of 73 consecutive adult patients with quiescent Crohn disease managed at Jinling Hospital in China between 2016 and 2020. Patients underwent lactulose hydrogen-methane breath testing to diagnose SIBO and were followed up for 18 months.

Overall, 46.6% of patients tested positive for SIBO. Over 18 months of follow-up, 37.0% experienced clinical relapse.

The rate of SIBO was 63.0% in the relapse group, according to the study, compared with 37.0% in the group that did not experience relapse. SIBO and penetrating disease behavior were the sole individual risk factors for Crohn disease relapse. Researchers reported clinical relapse hazard ratios of 2.79 with SIBO and 3.66 with penetrating disease behavior.

“The detection of SIBO may be a valuable option for the prognostic assessment of patients in clinical remission,” researchers advised. “However, more trials with larger sample sizes are needed in the future to better understand the prognostic value of SIBO and the effect of proactive treatment of SIBO on the prognosis of Crohn’s disease.”

—Jolynn Tumolo

Reference:
Wei J, Feng J, Chen L, et al. Small intestinal bacterial overgrowth is associated with clinical relapse in patients with quiescent Crohn’s disease: a retrospective cohort study. Ann Transl Med.. 2022;10(14):784.