Patients With SSc Carry Higher Risk of SIBO
Patients with systemic sclerosis (SSc) experience a significantly higher risk of developing small intestine bacterial overgrowth (SIBO) than healthy controls, according to a systematic review and meta-analysis.
Investigators in China sought to estimate the actual prevalence of SIBO among patients with SSc and to identify predictors of SIBO in these patients through an extensive search of the PubMed, Cochrane Library, and EMBASE databases for studies that correlated the 2 conditions.
The researchers identified 14 studies comprising 700 SSc patients with SSc and 217 healthy controls. Their analysis revealed that the pooled prevalence of SIBO in SSc was 34% (95% CI 27-42%) and the odds ratio of SIBO among patients with SSc was 12.51 (95% CI 6.51-24.03) compared with the healthy controls.
“Subgroup analyses showed that the prevalence of SIBO in SSc was higher in studies using the lactulose hydrogen breath test (LHBT) for diagnosis (56%, 95% CI 46-67%) compared with those that used the glucose hydrogen breath test (GHBT) (27%, 95%CI 20-35%) and a jejunal aspirated culture (JAC) (35%, 95%CI 25-51%),” the authors wrote.
Studies conducted in Asia showed a lower prevalence of SIBO among patients with SSc than those that were done in the Western hemisphere (15%, 95%CI 10-23% vs 38%, 95% CI 31-47%).
Patients with SSc and SIBO had a higher risk of diarrhea than did patients with SSc without SIBO
(OR 8.82, 95% CI 4.09-19, P < 0.00001. However, gender, SSc subset, digital ulcer, and pulmonary fibrosis did not appear to be associated with SIBO in SSc.
“The risk of SIBO in SSc was increased by nearly thirteenfold compared to the healthy controls,” the authors reported. “For SSc patients with SIBO, antibiotic treatment can lead to eradication of SIBO and gastrointestinal symptomatic improvement.
--Rebecca Mashaw
Reference:
Feng X, Li XQ, Jiang Z. Prevalence and predictors of small intestinal bacterial overgrowth in systemic sclerosis: a systematic review and meta-analysis. Clin Rheumatol. 2021;40(8):3039-3051. doi: 10.1007/s10067-020-05549-8
