J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://www.jocmr.org

Original Article

Volume 12, Number 10, October 2020, pages 655-661

Predictors of Small Intestinal Bacterial Overgrowth in Symptomatic Patients Referred for Breath Testing

Figure 1. Antibiotic treatment. BT: breath test; SIBO: small intestinal bacterial overgrowth; SIBO^-: group without SIBO; SIBO⁺: group with SIBO.

**Table 1.** Characteristics of Patients Who Completed a BT: Comparison Between the Two Groups SIBO^- and SIBO⁺
Characteristics	SIBO^-	SIBO⁺	OR	P value
BT: breath test; SIBO: small intestinal bacterial overgrowth; SIBO^-: group without SIBO; SIBO⁺: group with SIBO; BMI: body mass index; PPIs: proton pump inhibitors; OR: odds ratio; CI: confidence interval. ^aChronic kidney disease (kidney damage or glomerular filtration rate < 60 mL/min/1.73 m² for at least 3 months); ^bHemoglobin < 140 g/L in men and < 120 g/L in women.
Demographics
Mean age (year), mean (range)	50.49 (23 - 78)	52.72 (20 - 80)	-	0.39
BMI (kg/m²), mean (range)	25.41 (14.53 - 52.47)	24.88 (17.58 - 33.33)	-	0.71
Women (n)	63 % (57)	63% (29)	-	0.97
Habits
Smoking, % (n)	31.3 (5)	68.8 (11)	4.6 (95% CI 1.45 - 15.06)	0.01
Alcohol, % (n)	53.3 (8)	46.7 (7)	1.5 (95% CI 0.53 - 4.77)	0.41
Comorbidities
Diabetes, % (n)	64 (16)	36 (9)	1.0 (95% CI 0.53 - 4.77)	0.87
Chronic pancreatitis, % (n)	61.5 (16)	38.5 (10)	1.2 (95% CI 0.52 - 3.09)	0.60
Chronic kidney disease^a, % (n)	85.7 (6)	14.3 (1)	0.3 (95% CI 0.03 - 2.72)	0.30
Celiac disease, % (n)	50 (2)	50 (2)	1.9 (95% CI 0.26-14.52)	0.50
Abdominal surgeries, % (n)	70.4 (19)	29.6 (8)	0.7 (95% CI 0.30 - 1.93)	0.58
Scleroderma, % (n)	71.4 (5)	28.6 (2)	0.7 (95% CI 0.13 - 3.99)	0.73
Cirrhosis, % (n)	69.2 (18)	30.8 (8)	0.8 (95% CI 0.33 - 2.15)	0.73
PPI use, % (n)	67.4 (29)	32.6 (14)	0.9 (95% CI 0.41 - 2.07)	0.85
Anemia^b, % (n)	51.6 (16)	48.4 (15)	2.11 (95% CI 0.899 - 4.949)	0.08
Abdominal symptoms
Abdominal pain, % (n)	57.9 (44)	42.1 (32)	2.42 (95% CI 1.101 - 5.340)	0.02
Bloating, % (n)	72.1 (44)	27.9 (17)	1.58 (95% CI 0.746 - 3.337)	0.23
Diarrhea, % (n)	60.8 (31)	39.2 (20)	1.43 (95% CI 0.679 - 2.988)	0.34
Constipation, % (n)	61.9 (13)	38.1 (8)	1.27 (95% CI 0.480 - 3.336)	0.63

Table 1. Characteristics of Patients Who Completed a BT: Comparison Between the Two Groups SIBO^- and SIBO⁺

Characteristics

SIBO^-

SIBO⁺

P value

BT: breath test; SIBO: small intestinal bacterial overgrowth; SIBO^-: group without SIBO; SIBO⁺: group with SIBO; BMI: body mass index; PPIs: proton pump inhibitors; OR: odds ratio; CI: confidence interval. ^aChronic kidney disease (kidney damage or glomerular filtration rate < 60 mL/min/1.73 m² for at least 3 months); ^bHemoglobin < 140 g/L in men and < 120 g/L in women.

Demographics

Mean age (year), mean (range)

50.49 (23 - 78)

52.72 (20 - 80)

0.39

BMI (kg/m²), mean (range)

25.41 (14.53 - 52.47)

24.88 (17.58 - 33.33)

0.71

Women (n)

63 % (57)

63% (29)

0.97

Habits

Smoking, % (n)

31.3 (5)

68.8 (11)

4.6 (95% CI 1.45 - 15.06)

0.01

Alcohol, % (n)

53.3 (8)

46.7 (7)

1.5 (95% CI 0.53 - 4.77)

0.41

Comorbidities

Diabetes, % (n)

64 (16)

36 (9)

1.0 (95% CI 0.53 - 4.77)

0.87

Chronic pancreatitis, % (n)

61.5 (16)

38.5 (10)

1.2 (95% CI 0.52 - 3.09)

0.60

Chronic kidney disease^a, % (n)

85.7 (6)

14.3 (1)

0.3 (95% CI 0.03 - 2.72)

0.30

Celiac disease, % (n)

50 (2)

1.9 (95% CI 0.26-14.52)

0.50

Abdominal surgeries, % (n)

70.4 (19)

29.6 (8)

0.7 (95% CI 0.30 - 1.93)

0.58

Scleroderma, % (n)

71.4 (5)

28.6 (2)

0.7 (95% CI 0.13 - 3.99)

0.73

Cirrhosis, % (n)

69.2 (18)

30.8 (8)

0.8 (95% CI 0.33 - 2.15)

0.73

PPI use, % (n)

67.4 (29)

32.6 (14)

0.9 (95% CI 0.41 - 2.07)

0.85

Anemia^b, % (n)

51.6 (16)

48.4 (15)

2.11 (95% CI 0.899 - 4.949)

0.08

Abdominal symptoms

Abdominal pain, % (n)

57.9 (44)

42.1 (32)

2.42 (95% CI 1.101 - 5.340)

0.02

Bloating, % (n)

72.1 (44)

27.9 (17)

1.58 (95% CI 0.746 - 3.337)

0.23

Diarrhea, % (n)

60.8 (31)

39.2 (20)

1.43 (95% CI 0.679 - 2.988)

0.34

Constipation, % (n)

61.9 (13)

38.1 (8)

1.27 (95% CI 0.480 - 3.336)

0.63

**Table 2.** Association Between Characteristics and SIBO⁺ After Multivariate Analysis
Characteristics	OR	P value
Factors adjusted for in the multivariate analysis: age, gender, bloating, abdominal pain, constipation, diarrhea, weight loss, anemia, and smoking. SIBO: small intestinal bacterial overgrowth; SIBO⁺: group with SIBO; OR: odds ratio.
Bloating	5.39	0.01
Abdominal pain	4.78	0.01
Anemia	4.08	0.02
Smoking	6.66	0.01

Table 2. Association Between Characteristics and SIBO⁺ After Multivariate Analysis

Characteristics

P value

Factors adjusted for in the multivariate analysis: age, gender, bloating, abdominal pain, constipation, diarrhea, weight loss, anemia, and smoking. SIBO: small intestinal bacterial overgrowth; SIBO⁺: group with SIBO; OR: odds ratio.

Bloating

5.39

0.01

Abdominal pain

4.78

0.01

Anemia

4.08

0.02

Smoking

6.66

0.01

**Table 3.** Antibiotics Chosen for SIBO Treatment
Antibiotics	n = 38	%
SIBO: small intestinal bacterial overgrowth.
Metronidazole	15	39.5%
Ciprofloxacin	4	10.5%
Amoxicillin and clavulanate	4	10.5%
Amoxicillin	3	7.9%
Doxycycline	5	13.2%
Rifaximin	3	7.9%
Tetracycline	1	2.6%
Minocycline	1	2.6%
Norfloxacin	1	2.6%
Trimethoprim-sulfamethoxazole	1	2.6%

Table 3. Antibiotics Chosen for SIBO Treatment

Antibiotics

n = 38

SIBO: small intestinal bacterial overgrowth.

Metronidazole

39.5%

Ciprofloxacin

10.5%

Amoxicillin and clavulanate

10.5%

Amoxicillin

7.9%

Doxycycline

13.2%

Rifaximin

7.9%

Tetracycline

2.6%

Minocycline

2.6%

Norfloxacin

2.6%

Trimethoprim-sulfamethoxazole

2.6%