Liver Problems and SIBO

A growing number of clinicians are recognizing that liver disease may increase Small Intestinal bacterial Overgrowth (SIBO) risk. The association has been noted in several medical journals:

• In a German study reported in the October 2001 issue of The American Journal of Gastroenterology, researchers found that 61 percent of patients with cirrhosis had SIBO.
• In a report published by Chinese researchers in the April 2010 issue of Alimentary Pharmacology and Therapeutics, the researchers reported that SIBO increases the incidence of lactose intolerance.
• In a study recently published in a March 2014 issue of the British Journal of Medicine and Medical Research, researchers found that lactose intolerance was noted in 72 percent of Italian patients with SIBO.
• In an Indian study published in a June 2009 issue of Alimentary Pharmacology & Therapeutics, researchers found that SIBO was present in about half of those with liver cirrhosis. They also concluded that the prevalence of SIBO increased with cirrhosis severity.
• In an Irish study published in a May 2011 issue of Digestive Diseases and Sciences, researchers found that SIBO was more common in people with non-alcoholic steatohepatitis (an advanced form of fatty liver disease) at nearly 78 percent than those with a healthy liver at 30 percent.

Clinicians should consider testing patients with liver disease using the hydrogen breath test to determine if SIBO is present. Testing and, if necessary treating these patients will improve their quality of life.