Liver disease symptoms in non-alcoholic fatty liver disease and small intestinal bacterial overgrowth

Rom J Intern Med. 2018 Jun 1;56(2):85-89. doi: 10.1515/rjim-2017-0042.


Introduction: It seems that there is a relationship between small intestinal bacterial overgrowth (SIBO) and non-alcoholic fatty liver disease (NAFLD). The main objective of this study was to evaluate the prevalence of SIBO among NAFLD patients.

Methods: In this descriptive-analytical cross-sectional study, 98 eligible NAFLD patients were evaluated for SIBO using hydrogen breath test (HBT). They were divided into SIBO-positive and SIBO-negative groups. Demographic, clinical, and laboratory data were obtained.

Results: Based on the HBT, 38 patients (39%) had bacteria overgrowth. There were no significant differences between SIBO-positive and SIBO-negative regarding demographic data and BMI classification (P > 0.05). Biochemical variables, the results of abdominal ultrasound, and liver elastography did not show any significant difference between SIBO-positive and SIBO-negative patients (P > 0.05). Patients with SIBO were found to have higher rates of bloating, while abdominal pain was more prevalent in SIBO-negative patients (P < 0.001).

Conclusions: SIBO is prevalent in NAFLD and associated with bloating in these patients. Further studies are necessary to elucidate if therapeutic manipulation of gut microbiota reduces the risk of NAFLD, fibrosis, and liver cirrhosis.

Keywords: Abdominal pain; Breath tests; Non-alcoholic fatty liver disease; Small intestinal bacterial overgrowth.

MeSH terms

  • Abdominal Pain / etiology
  • Adult
  • Blind Loop Syndrome / complications*
  • Blind Loop Syndrome / epidemiology
  • Body Mass Index
  • Breath Tests
  • Comorbidity
  • Cross-Sectional Studies
  • Elasticity Imaging Techniques
  • Female
  • Humans
  • Intestine, Small / microbiology*
  • Male
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease / complications*
  • Non-alcoholic Fatty Liver Disease / epidemiology
  • Obesity / complications
  • Prevalence
  • Risk Factors