{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T16:13:54Z","timestamp":1790784834446,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T00:00:00Z","timestamp":1656633600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T00:00:00Z","timestamp":1656633600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000923","name":"Australian Research Council","doi-asserted-by":"publisher","award":["APP170993"],"award-info":[{"award-number":["APP170993"]}],"id":[{"id":"10.13039\/501100000923","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP1084544"],"award-info":[{"award-number":["APP1084544"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Symptoms of small intestinal bacterial overgrowth (SIBO) and celiac disease (CeD) often overlap, and studies suggest a link between SIBO and CeD. We thus conducted a systematic review and meta\u2010analysis to compare SIBO prevalence in CeD patients and controls and assessed effects of antimicrobial therapy on gastrointestinal symptoms in SIBO positive CeD patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Electronic databases were searched until February 2022 for studies reporting SIBO prevalence in CeD. Prevalence rates, odds ratio (OR), and 95% confidence intervals (CI) of SIBO in CeD and controls were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 14 studies, with 742 CeD patients and 178 controls. The pooled prevalence of SIBO in CeD was 18.3% (95% CI: 11.4\u201328.1), with substantial heterogeneity. Including case\u2013control studies with healthy controls, SIBO prevalence in CeD patients was significantly increased (OR 5.1, 95% CI: 2.1\u201312.4, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.0001), with minimal heterogeneity. Utilizing breath tests, SIBO prevalence in CeD patients was 20.8% (95% CI: 11.9\u201333.7), almost two\u2010fold higher compared with culture\u2010based methods at 12.6% (95% CI: 5.1\u201328.0), with substantial heterogeneity in both analyses. SIBO prevalence in CeD patients nonresponsive to a gluten free diet (GFD) was not statistically higher as compared with those responsive to GFD (OR 1.5, 95% CI: 0.4\u20135.0, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.511). Antibiotic therapy of SIBO positive CeD patients resulted in improvement in gastrointestinal symptoms in 95.6% (95% CI: 78.0\u201399.9) and normalization of breath tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study suggests a link between SIBO and CeD. While SIBO could explain nonresponse to a GFD in CeD, SIBO prevalence is not statistically higher in CeD patients non\u2010responsive to GFD. The overall quality of the evidence is low, mainly due to substantial \u201cclinical heterogeneity\u201d and the limited sensitivity\/specificity of the available diagnostic tests.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.15920","type":"journal-article","created":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T06:39:06Z","timestamp":1655966346000},"page":"1844-1852","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Links between celiac disease and small intestinal bacterial overgrowth: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"37","author":[{"given":"Ayesha","family":"Shah","sequence":"first","affiliation":[{"name":"Faculty of Medicine The University of Queensland  Brisbane Queensland Australia"},{"name":"Department of Gastroenterology and Hepatology Princess Alexandra Hospital  Woolloongabba Queensland Australia"},{"name":"Translational Research Institute  Woolloongabba Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parag","family":"Thite","sequence":"additional","affiliation":[{"name":"Faculty of Medicine The University of Queensland  Brisbane Queensland Australia"},{"name":"Department of Gastroenterology and Hepatology Princess Alexandra Hospital  Woolloongabba Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teressa","family":"Hansen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine The University of Queensland  Brisbane Queensland Australia"},{"name":"Department of Gastroenterology and Hepatology Princess Alexandra Hospital  Woolloongabba Queensland Australia"},{"name":"Translational Research Institute  Woolloongabba Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley J","family":"Kendall","sequence":"additional","affiliation":[{"name":"Faculty of Medicine The University of Queensland  Brisbane Queensland Australia"},{"name":"Department of Gastroenterology and Hepatology Princess Alexandra Hospital  Woolloongabba Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S","family":"Sanders","sequence":"additional","affiliation":[{"name":"Academic Unit of Gastroenterology Sheffield Teaching Hospitals NHS Foundation Trust  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Morrison","sequence":"additional","affiliation":[{"name":"Faculty of Medicine The University of Queensland  Brisbane Queensland Australia"},{"name":"Department of Gastroenterology and Hepatology Princess Alexandra Hospital  Woolloongabba Queensland Australia"},{"name":"Diamantina Institute The University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael P","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Psychology Macquarie University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0206-2358","authenticated-orcid":false,"given":"Gerald","family":"Holtmann","sequence":"additional","affiliation":[{"name":"Faculty of Medicine The University of Queensland  Brisbane Queensland Australia"},{"name":"Department of Gastroenterology and Hepatology Princess Alexandra Hospital  Woolloongabba Queensland Australia"},{"name":"Translational Research Institute  Woolloongabba Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,7]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra071600"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.79"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2006.12.006"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2002.05917.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12456"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2001.03533.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2010.07.007"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-230X-3-9"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2011.01686.x"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-007-0065-1"},{"key":"e_1_2_6_12_1","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/B978-0-323-54843-4.00006-4","volume-title":"Clinical Conditions Associated with Small Intestinal Bacterial Overgrowth. Gastrointestinal Diseases and their Associated Infections","author":"Shah A","year":"2019"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11938-018-0207-x"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e3181557e67"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2003.07379.x"},{"key":"e_1_2_6_16_1","first-page":"159","article-title":"Small intestinal bacterial overgrowth in North Indian patients with celiac disease","volume":"28","author":"Rana SV","year":"2007","journal-title":"Trop. Gastroenterol."},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2535"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12664-020-01107-x"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/XEB.0000000000000054"},{"key":"e_1_2_6_20_1","volume-title":"The Newcastle\u2010Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta\u2010Analyses","author":"Wells GA","year":"2000"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.22848"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.5152\/tjg.2020.19627"},{"key":"e_1_2_6_23_1","first-page":"171","article-title":"Small intestinal bacterial overgrowth prevalence in celiac disease patients is similar in healthy subjects and lower in irritable bowel syndrome patients","volume":"80","author":"Lasa JS","year":"2015","journal-title":"Rev. Gastroenterol. Mex."},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12681"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v18.i12.1348"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/23.12.1602"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2011.04625.x"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-011-1719-6"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-230X-4-10"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2004.40406.x"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1080\/19490976.2021.1933313"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.15133"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000501"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2013.08.128"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2000.00768.x"},{"key":"e_1_2_6_36_1","first-page":"49","article-title":"Quantitative PCR as a novel approach to determine influence of density of bacterial colonization on health and disease","volume":"33","author":"Shah A","year":"2018","journal-title":"J. Gastroenterol. Hepatol."},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-017-1371-9"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13028"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000002497"}],"container-title":["Journal of Gastroenterology and Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgh.15920","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jgh.15920","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgh.15920","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgh.15920","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T03:38:27Z","timestamp":1692675507000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jgh.15920"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7]]},"references-count":38,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2022,10]]}},"alternative-id":["10.1111\/jgh.15920"],"URL":"https:\/\/doi.org\/10.1111\/jgh.15920","archive":["Portico"],"relation":{},"ISSN":["0815-9319","1440-1746"],"issn-type":[{"value":"0815-9319","type":"print"},{"value":"1440-1746","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7]]},"assertion":[{"value":"2022-05-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}