{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T19:17:00Z","timestamp":1793647020119,"version":"4.5.1"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T00:00:00Z","timestamp":1737417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Small intestinal bacterial overgrowth (SIBO) has been reported to be very common among individuals with inflammatory bowel disease (IBD), and the prevalence of SIBO is highly variable. We conducted this study to calculate the prevalence and identify predictors of SIBO in IBD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>PubMed, Cochrane Library, and EMBASE from inception to March 2024 were searched for studies evaluating the prevalence of SIBO in IBD. We calculated the pooled prevalence of SIBO among IBD patients and the odds ratio (OR) of SIBO in IBD compared with healthy controls. Besides, we also evaluated predictors of SIBO in IBD patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty-nine studies (3,250 IBD, 708 controls) were included in our study. The pooled prevalence of SIBO in IBD was 31.0% (95% CI 25.2\u201337.1), and the prevalence of SIBO was higher in IBD compared with healthy controls (OR 5.25, 95% CI 2.96\u20139.32). The pooled prevalence of SIBO was higher among CD patients (32.2, 95% CI 25.9\u201338.8) compared with UC patients (27.8, 95% CI 18.5\u201338.1). The odds of lower BMI (mean difference\u202f=\u202f\u22121.04; 95% CI \u22121.86 to \u22120.23), bloating (OR\u202f=\u202f3.02, 95% CI 1.22\u20137.5), flatulence (OR\u202f=\u202f4.70, 95% CI 1.44\u201315.35), history of abdominal surgery (OR\u202f=\u202f2.05, 95% CI 1.35\u20133.11), and stricturing\/penetrating disease behavior (OR\u202f=\u202f3.51, 95% CI 1.67\u20137.40) increased significantly in IBD patients with SIBO compared to those without SIBO. Antibiotic treatment may be effective for SIBO in IBD patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Nearly one-third of IBD patients present with SIBO positive, and the odds of SIBO in IBD was increased by 5.25-fold compared with healthy controls. Lower BMI, bloating, flatulence, history of abdominal surgery, and stricturing\/penetrating disease behavior were predictors of SIBO in IBD patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2024.1490506","type":"journal-article","created":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T16:00:37Z","timestamp":1737475237000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Prevalence and predictors of small intestinal bacterial overgrowth in inflammatory bowel disease: a meta-analysis"],"prefix":"10.3389","volume":"11","author":[{"given":"Xin","family":"Feng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1007\/s00535-021-01784-1","article-title":"Evidence-based clinical practice guidelines for inflammatory bowel disease 2020","volume":"56","author":"Nakase","year":"2021","journal-title":"J Gastroenterol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"s1","DOI":"10.1136\/gutjnl-2019-318484","article-title":"British society of gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults","volume":"68","author":"Lamb","year":"2019","journal-title":"Gut"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"2077","DOI":"10.3390\/ijms25042077","article-title":"Recent trends in non-invasive methods of diagnosis and evaluation of inflammatory bowel disease: a short review","volume":"25","author":"V\u0103lean","year":"2024","journal-title":"Int J Mol Sci"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1016\/S2468-1253(23)00284-4","article-title":"Challenges in the diagnosis and treatment of inflammatory bowel disease in Latin America","volume":"9","author":"Balderramo","year":"2024","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"165","DOI":"10.14309\/ajg.0000000000000501","article-title":"ACG clinical guideline: small intestinal bacterial overgrowth","volume":"115","author":"Pimentel","year":"2020","journal-title":"Am J Gastroenterol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1053\/j.gastro.2022.04.002","article-title":"Small intestinal bacterial overgrowth-pathophysiology and its implications for definition and management","volume":"163","author":"Bushyhead","year":"2022","journal-title":"Gastroenterology"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1038\/ajg.2017.46","article-title":"Hydrogen and methane-based breath testing in gastrointestinal disorders: the North American consensus","volume":"112","author":"Rezaie","year":"2017","journal-title":"Am J Gastroenterol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1111\/apt.15133","article-title":"Systematic review with meta-analysis: the prevalence of small intestinal bacterial overgrowth in inflammatory bowel disease","volume":"49","author":"Shah","year":"2019","journal-title":"Aliment Pharmacol Ther"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1933313","DOI":"10.1080\/19490976.2021.1933313","article-title":"Methane positive small intestinal bacterial overgrowth in inflammatory bowel disease and irritable bowel syndrome: a systematic review and meta-analysis","volume":"13","author":"Gandhi","year":"2021","journal-title":"Gut Microbes"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e1000097","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"6","author":"Moher","year":"2009","journal-title":"PLoS Med"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"iii","DOI":"10.3310\/hta7270","article-title":"Evaluating non-randomised intervention studies","volume":"7","author":"Deeks","year":"2003","journal-title":"Health Technol Assess"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1097\/XEB.0000000000000054","article-title":"Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data","volume":"13","author":"Munn","year":"2015","journal-title":"Int J Evid Based Healthc"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"BMJ"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1539","DOI":"10.1002\/sim.1186","article-title":"Quantifying heterogeneity in a meta-analysis","volume":"21","author":"Higgins","year":"2002","journal-title":"Stat Med"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"935","DOI":"10.3390\/jcm12030935","article-title":"Impact of small intestinal bacterial overgrowth in patients with inflammatory bowel disease and other gastrointestinal disorders-a retrospective analysis in a tertiary single center and review of the literature","volume":"12","author":"Wanzl","year":"2023","journal-title":"J Clin Med"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"49","DOI":"10.31146\/1682-8658-ecg-212-4-49-54","article-title":"Excessive bacterial growth syndrome in small intestine burdens the clinical picture of inflammatory bowel diseases","volume":"4","author":"Kulygin","year":"2023","journal-title":"Exp Clin Gastroenterol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"otad017","DOI":"10.1093\/crocol\/otad017","article-title":"The impact of confounders on symptom-endoscopic discordances in Crohn's disease","volume":"5","author":"Rajan","year":"2023","journal-title":"Crohns Colitis 360"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"784","DOI":"10.21037\/atm-22-3335","article-title":"Small intestinal bacterial overgrowth is associated with clinical relapse in patients with quiescent Crohn's disease: a retrospective cohort study","volume":"10","author":"Wei","year":"2022","journal-title":"Ann Transl Med"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1007\/s12664-021-01211-6","article-title":"Small intestinal bacterial overgrowth in patients with inflammatory bowel disease: a case-control study","volume":"41","author":"Ghoshal","year":"2022","journal-title":"Indian J Gastroenterol"},{"key":"ref20","first-page":"6605","article-title":"Small intestinal bacterial overgrowth and evaluation of intestinal barrier function in patients with ulcerative colitis","volume":"13","author":"Yang","year":"2021","journal-title":"Am J Transl Res"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"2941","DOI":"10.19193\/0393-6384_2021_5_454","article-title":"Small intestinal bacterial overgrowth and low-grade systemic inflammation in patients with inflammatory bowel disease","volume":"37","author":"Tong","year":"2021","journal-title":"Acta Med Mediterr"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"245","DOI":"10.29271\/jcpsp.2020.03.245","article-title":"Relationship between small intestinal bacterial overgrowth and peripheral blood ET, TLR2 and TLR4 in ulcerative colitis","volume":"30","author":"Yang","year":"2020","journal-title":"J Coll Physicians Surg Pak"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1111\/apt.15786","article-title":"Duodenal bacterial load as determined by quantitative polymerase chain reaction in asymptomatic controls, functional gastrointestinal disorders and inflammatory bowel disease","volume":"52","author":"Shah","year":"2020","journal-title":"Aliment Pharmacol Ther"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"S439","DOI":"10.14309\/01.ajg.0000705456.97559.1b","article-title":"An analysis of small intestine bacterial overgrowth rates in ulcerative colitis","volume":"115","author":"Lorio","year":"2020","journal-title":"Am J Gastroenterol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"2388","DOI":"10.1007\/s10620-019-05967-y","article-title":"Breath test gas patterns in inflammatory bowel disease with concomitant irritable bowel syndrome-like symptoms: a controlled large-scale database linkage analysis","volume":"65","author":"Gu","year":"2020","journal-title":"Dig Dis Sci"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1590\/S0004-2803.202000000-64","article-title":"Prevalence and factors associated with small intestinal bacterial overgrowth in patients with CROHN'S disease: a retrospective study at a referral center","volume":"57","author":"Bertges","year":"2020","journal-title":"Arq Gastroenterol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"S544","DOI":"10.1093\/ecco-jcc\/jjy222.965","article-title":"Small intestinal bacterial overgrowth in patients with Crohn's disease is not only associated with a more severe disease, but is also marked by dramatic changes in the gut microbiome","volume":"13","author":"Kulygina","year":"2019","journal-title":"J Crohn's Colitis"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1097\/MCG.0000000000000803","article-title":"Small-intestinal bacterial overgrowth is associated with concurrent intestinal inflammation but not with systemic inflammation in Crohn's disease patients","volume":"52","author":"Ricci","year":"2018","journal-title":"J Clin Gastroenterol"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"2439","DOI":"10.1007\/s10620-018-5109-1","article-title":"Testing and treating small intestinal bacterial overgrowth reduces symptoms in patients with inflammatory bowel disease","volume":"63","author":"Cohen-Mekelburg","year":"2018","journal-title":"Dig Dis Sci"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1111\/1751-2980.12665","article-title":"Abstracts published only","volume":"19","author":"Chen","year":"2018","journal-title":"J Dig Dis"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"151","DOI":"10.12865\/CHSJ.42.02.06","article-title":"Small intestinal bacterial overgrowth syndrome prevalence in Romanian patients with inflammatory bowel disease","volume":"42","author":"Andrei","year":"2016","journal-title":"Curr Health Sci J"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"990","DOI":"10.1111\/jgh.12908","article-title":"Clinical significance of the glucose breath test in patients with inflammatory bowel disease","volume":"30","author":"Lee","year":"2015","journal-title":"J Gastroenterol Hepatol"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1376","DOI":"10.3109\/00365521.2015.1050691","article-title":"Glucose breath test and Crohn's disease: diagnosis of small intestinal bacterial overgrowth and evaluation of therapeutic response","volume":"50","author":"Greco","year":"2015","journal-title":"Scand J Gastroenterol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"13999","DOI":"10.3748\/wjg.v20.i38.13999","article-title":"Small intestinal bacterial overgrowth in inactive Crohn's disease: influence of thiopurine and biological treatment","volume":"20","author":"S\u00e1nchez-Montes","year":"2014","journal-title":"World J Gastroenterol"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1016\/j.crohns.2014.01.007","article-title":"Relationship of cytokines, oxidative stress and GI motility with bacterial overgrowth in ulcerative colitis patients","volume":"8","author":"Rana","year":"2014","journal-title":"J Crohns Colitis"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"2594","DOI":"10.1007\/s10620-013-2694-x","article-title":"Small intestinal bacterial overgrowth and orocecal transit time in patients of inflammatory bowel disease","volume":"58","author":"Rana","year":"2013","journal-title":"Dig Dis Sci"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1186\/1471-230X-9-61","article-title":"Small intestinal bacterial overgrowth mimicking acute flare as a pitfall in patients with Crohn's disease","volume":"9","author":"Klaus","year":"2009","journal-title":"BMC Gastroenterol"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1097\/00042737-200301000-00012","article-title":"Assessment of orocaecal transit time in different localization of Crohn's disease and its possible influence on clinical response to therapy","volume":"15","author":"Tursi","year":"2003","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"1107","DOI":"10.1046\/j.1365-2036.2003.01800.x","article-title":"Antibiotic treatment of small bowel bacterial overgrowth in patients with Crohn's disease","volume":"18","author":"Castiglione","year":"2003","journal-title":"Aliment Pharmacol Ther"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1023\/a:1017991313789","article-title":"The glucose breath test: a diagnostic test for small bowel stricture (s) in Crohn's disease","volume":"47","author":"Mishkin","year":"2002","journal-title":"Dig Dis Sci"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1097\/00004836-200007000-00015","article-title":"Orocecal transit time and bacterial overgrowth in patients with Crohn's disease","volume":"31","author":"Castiglione","year":"2000","journal-title":"J Clin Gastroenterol"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1007\/BF01297052","article-title":"Factors affecting methane production in humans","volume":"32","author":"Peled","year":"1987","journal-title":"Dig Dis Sci"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1111\/j.1365-2362.1981.tb01841.x","article-title":"Ileal dysfunction and bacterial overgrowth in patients with Crohn's disease","volume":"11","author":"Rutgeerts","year":"1981","journal-title":"Eur J Clin Investig"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"1623","DOI":"10.3390\/ijms22041623","article-title":"Impact of microbial metabolites on microbiota-gut-brain axis in inflammatory bowel disease","volume":"22","author":"Banfi","year":"2021","journal-title":"Int J Mol Sci"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"1013","DOI":"10.12998\/wjcc.v8.i6.1013","article-title":"Microbiota-gut-brain axis and its affect inflammatory bowel disease: pathophysiological concepts and insights for clinicians","volume":"8","author":"Sinagra","year":"2020","journal-title":"World J Clin Cases"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"115949","DOI":"10.1016\/j.bcp.2023.115949","article-title":"Gut-brain axis interacts with immunomodulation in inflammatory bowel disease","volume":"219","author":"Ye","year":"2024","journal-title":"Biochem Pharmacol"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"8787","DOI":"10.3748\/wjg.v21.i29.8787","article-title":"Role of the normal gut microbiota","volume":"21","author":"Jandhyala","year":"2015","journal-title":"World J Gastroenterol"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"2247","DOI":"10.3389\/fmicb.2018.02247","article-title":"The gut microbiota in the pathogenesis and therapeutics of inflammatory bowel disease","volume":"9","author":"Zuo","year":"2018","journal-title":"Front Microbiol"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1016\/j.tig.2004.05.007","article-title":"Evolution of cell\u2013cell signaling in animals: did late horizontal gene transfer from bacteria have a role?","volume":"20","author":"Iyer","year":"2004","journal-title":"Trends Genet"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"G1288","DOI":"10.1152\/ajpgi.00341.2012","article-title":"Critical role of gut microbiota in the production of biologically active, free catecholamines in the gut lumen of mice","volume":"303","author":"Asano","year":"2012","journal-title":"Am J Physiol Gastrointest Liver Physiol"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1038\/s41575-019-0258-z","article-title":"Gut microbiota-derived metabolites as key actors in inflammatory bowel disease","volume":"17","author":"Lavelle","year":"2020","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"ref52","article-title":"Small intestinal bacterial overgrowth","volume-title":"Stat pearls [Internet].","author":"Sorathia","year":"2023"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"2978","DOI":"10.3748\/wjg.v16.i24.2978","article-title":"Small intestinal bacterial overgrowth syndrome","volume":"16","author":"Bures","year":"2010","journal-title":"World J Gastroenterol"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"1964","DOI":"10.1016\/j.cgh.2013.09.055","article-title":"Breath testing for small intestinal bacterial overgrowth: maximizing test accuracy","volume":"12","author":"Saad","year":"2014","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1136\/gut.2009.205476","article-title":"Combined oro-caecal scintigraphy and lactulose hydrogen breath testing demonstrate that breath testing detects oro-caecal transit, not small intestinal bacterial overgrowth in patients with IBS","volume":"60","author":"Yu","year":"2011","journal-title":"Gut"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1186\/s12967-017-1175-y","article-title":"Influence of diet on the gut microbiome and implications for human health","volume":"15","author":"Singh","year":"2017","journal-title":"J Transl Med"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.jcmgh.2016.10.004","article-title":"Mechanisms of intestinal epithelial barrier dysfunction by adherent-invasive Escherichia Coli","volume":"3","author":"Shawki","year":"2017","journal-title":"Gastroenterol Hepatol"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"1463","DOI":"10.1016\/j.jcmgh.2021.02.007","article-title":"Regulation of intestinal barrier function by microbial metabolites","volume":"11","author":"Ghosh","year":"2021","journal-title":"Cell Mol Gastroenterol Hepatol"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"e1008208","DOI":"10.1371\/journal.ppat.1008208","article-title":"B vitamin acquisition by gut commensal bacteria","volume":"16","author":"Putnam","year":"2020","journal-title":"PLoS Pathog"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"1269","DOI":"10.1007\/s10620-014-3166-7","article-title":"Low ileocecal valve pressure is significantly associated with small intestinal bacterial overgrowth (SIBO)","volume":"59","author":"Roland","year":"2014","journal-title":"Dig Dis Sci"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1490506\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T16:00:40Z","timestamp":1737475240000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1490506\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,21]]},"references-count":60,"alternative-id":["10.3389\/fmed.2024.1490506"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2024.1490506","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,21]]},"article-number":"1490506"}}