Prevalence and associated factors of small intestinal bacterial overgrowth among systemic sclerosis patients

Int J Rheum Dis. 2019 Apr;22(4):695-699. doi: 10.1111/1756-185X.13495. Epub 2019 Feb 6.


Background: Small intestinal bacterial overgrowth (SIBO) results in nutrient malabsorption and malnutrition, thereby increasing the morbidity and mortality in systemic sclerosis (SSc) patients.

Objectives: To evaluate the prevalence and associated factors of SIBO in SSc patients.

Method: A cross-sectional study was conducted between July 2015 and January 2016 in SSc patients over 18, using the glucose H2 /CH4 breath test to evaluate SIBO.

Results: Eighty-nine SSc patients (30 male and 59 female) underwent the glucose H2 /CH4 breath test. The mean age was 54.4. Twelve participants were positive for the glucose H2 /CH4 breath test, yielding a SIBO prevalence of 13.5% (95% CI 7.2-22.4) among SSc patients. A multivariate analysis revealed that duration of disease >5 years was significantly associated with SIBO (adjusted odds ratio 9.38; 95% CI 1.09-80.47).

Conclusion: The prevalence of SIBO, using the glucose H2 /CH4 breath test, is not common among Thai SSc patients. However, a positive result was associated with longer duration of disease.

Keywords: hydrogen breath test; scleroderma; small intestinal bacterial overgrowth; systemic sclerosis.

MeSH terms

  • Adult
  • Aged
  • Bacteria / growth & development*
  • Blind Loop Syndrome / diagnosis
  • Blind Loop Syndrome / epidemiology*
  • Blind Loop Syndrome / microbiology
  • Breath Tests
  • Cross-Sectional Studies
  • Female
  • Gastrointestinal Microbiome*
  • Humans
  • Intestine, Small / microbiology*
  • Male
  • Middle Aged
  • Prevalence
  • Risk Assessment
  • Risk Factors
  • Scleroderma, Systemic / diagnosis
  • Scleroderma, Systemic / epidemiology*
  • Scleroderma, Systemic / microbiology
  • Thailand / epidemiology
  • Time Factors