The Correlation of Small Intestinal Bacterial Overgrowth, Orocecal Transit Time and Gastrointestinal Symptoms in Patients with Liver Cirrhosis

Abstract

Background/Aims: Delayed orocecal transit time (OCTT) and presence of small intestinal bacterial overgrowth (SIBO) may contribute to the common gastrointestinal symptoms in patient with cirrhosis. However, not much is known how SIBO and OCTT would affect gastrointestinal symptoms in cirrhotic patients. The objective of this study was to investigate the correlation of SIBO, OCTT and gastrointestinal symptoms in cirrhotic patients. Methods: The lactulose breath test was used to measure SIBO and OCTT on 40 cirrhotic patients and 40 healthy volunteers. A questionnaire was completed in 40 cirrhotic patients. Results: SIBO was diagnosed on 23 (57.7%) of 40 cirrhotic patients and on 11 (27.5%) of 40 controls (p = 0.012). SIBO positive patients showed higher constipation score (1.30 vs. 0.47, p = 0.05) and hard stool score (0.87 vs. 0.18, p = 0.02) than SIBO negative patients. OCTT was slower in cirrhotic patients compared to healthy controls (140 ± 29 min vs. 116 ± 20 min, p = 0.001) and slower in SIBO positive group compared to SIBO negative group (136 ± 25 min vs. 120 ± 28 min, p = 0.035). Delayed OCTT was associated with hard stool score (r = 0.44, p = 0.02). Conclusions: Delayed OCTT and higher prevalence of SIBO were noted in cirrhotic patients. SIBO positive cirrhotic patients showed higher constipation score and hard stool score than SIBO negative patients.