Evidence map›Paper›PMID 39844931›Full record

ArticleEClinicalMedicine2025

Small intestinal bacterial overgrowth in chronic liver disease: an updated systematic review and meta-analysis of case-control studies.

Ayesha Shah, Liam Spannenburg, Parag Thite, Mark Morrison, Thomas Fairlie, Natasha Koloski, Purna C Kashyap, Mark Pimentel, Ali Rezaie, Gregory J Gores and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in EClinicalMedicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

  1. Article
  2. Critical Review: The Past, Present, and Future of Small Intestinal Bacterial Overgrowth (SIBO).JGH open : an open access journal of gastroenterology and hepatology · 2026
    Review
  3. Article
  4. Review
  5. Article
  6. Review
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  8. Review
  9. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Ayesha ShahFaculty of Medicine, University of Queensland, Australia.
Liam SpannenburgFaculty of Medicine, University of Queensland, Australia.
Parag ThiteFaculty of Medicine, University of Queensland, Australia.
Mark MorrisonFaculty of Medicine, University of Queensland Frazer Institute, Woolloongabba, QLD, Australia.
Thomas FairlieFaculty of Medicine, University of Queensland, Australia.
Natasha KoloskiFaculty of Medicine, University of Queensland, Australia.
Purna C KashyapDivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Mark PimentelKarsh Division of Gastroenterology and Hepatology, Department of Medicine, Medically Associated Science and Technology Program, Cedars-Sinai, Los Angeles, CA, USA.
Ali RezaieKarsh Division of Gastroenterology and Hepatology, Department of Medicine, Medically Associated Science and Technology Program, Cedars-Sinai, Los Angeles, CA, USA.
Gregory J GoresDivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Michael P JonesMacquarie University, Department of Psychology, Sydney, NSW, Australia.
Gerald HoltmannFaculty of Medicine, University of Queensland, Australia.

Funding

MECHANISMS OF VISCERAL PAIN DRIVEN BY SMALL INTESTINAL MICROBIOTAR01DK138818 · MAYO CLINIC ROCHESTER · 2025 to 2025
$803k
NIDDK NIH HHS R01 DK138818
6 · The paper itself

Abstract

Background: Small Intestinal Bacterial Overgrowth (SIBO) has been implicated in the pathophysiology of chronic liver disease (CLD). We conducted a systematic review and meta-analysis to assess and compare the prevalence of SIBO among CLD patients (with and without with complications of end stage liver disease) and healthy controls. Methods: Electronic databases were searched from inception up to July-2024 for case-control studies reporting SIBO in CLD. Prevalence rates, odds ratios (ORs), and 95% confidence intervals (CIs) of SIBO in patients with CLD and controls were calculated utilizing a random-effects model. The protocol was prospectively registered with PROSPERO (CRD42022379578). Findings: The final dataset included 34 case-control studies with 2130 CLD patients and 1222 controls. Overall, the odds for SIBO prevalence in CLD patients compared to controls was 6.7 (95% CI 4.6-9.7, p < 0.001). Although the prevalence of SIBO among patients with CLD with cirrhosis was higher at 42.9% (95% CI: 35.9-50.2) compared to 36.9% (95% CI: 27.4-47.6) in those without cirrhosis, this difference failed statistical significance. However, CLD patients with decompensated cirrhosis had a significantly higher prevalence of SIBO compared to those with compensated cirrhosis, with an OR of 2.6 (95% CI: 1.5-4.5, p < 0.001). Additionally, the prevalence of SIBO was significantly higher in CLD patients with portal hypertension (PHT) than in those without PHT, with an OR of 2.1 (95% CI: 1.4-3.1, p < 0.001). The highest prevalence of SIBO was observed in patients with spontaneous bacterial peritonitis (SBP) (57.7%, 95% CI 38.8-74.5), followed by patients with hepatic encephalopathy (41.0%, 95% CI 16.0-72.3) and patients with variceal bleed (39.5%, 95% CI 12.1-75.6). Interpretation: Overall, there is a significantly increased prevalence of SIBO in CLD patients compared to controls. The prevalence is even higher in CLD patients with PHT, especially those with SBP. This meta-analysis suggests that SIBO is associated with complications of CLD and potentially linked to the progression of CLD. Funding: National Health and Medical Research Council, Centre for Research Excellence (APP170993).

Indexed as

Bacterial overgrowthBreath testsChronic liver diseaseCirrhosisMASLDMeta-analysisNAFLDSIBO

Identifiers

PMID39844931
PMCPMC11751576

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.