Meta-analysis And Systematic Evaluation Of The Incidence Of Small Intestinal Bacterial Overgrowth In Patients With Chronic Pancreatitis And Non-chronic Pancreatitis

Objective:To analyze the incidence of small intestinal bacterial overgrowth(SIBO)in patients with chronic pancreatitis(CP)and non-chronic pancreatitis,and to analyze the relationship between SIBO and symptoms and nutritional status.Methods:A clinically controlled study comparing the incidence of SIBO with CP and non-chronic pancreatitis published in relevant databases at home and abroad was conducted.The search time was until December 2018.The quality of the included literature was evaluated and the desired outcomes in the literature were extracted and analyzed using Revman 5.3 software.Heterogeneity was included in the literature and the prevalence of SIBO in patients with CP was calculated.If heterogeneity exists,subgroup analysis and sensitivity analysis were used to trace the source of heterogeneity.Results:A total of 9 articles were included,in a total of 644 subjects.Among patients with CP,the combined prevalence of SIBO was 29.7%,which was higher than that of the control group(OR=4.29,95%CI:1.81-10.15,P=0.009,I~2=63%),and the heterogeneity was greater.In a subgroup analysis,in all 6 studies using the glucose hydrogen breath test(GHBT)to diagnose SIBO,the combined prevalence of SIBO in CP patients was20.8%,higher than the control group(OR=2.29,95%CI:1.11-4.71,P=0.25,I~2=26%),and the heterogeneity is significantly reduced.Excluding the 6 studies of previous surgical history,the combined prevalence of SIBO in CP patients was 24.2%,higher than the control group(OR=4.73,95%CI:1.69-13.27,P=0.08,I~2=52%).Heterogeneity is also low.The relationship between symptoms and nutritional status and SIBO in patients with CP varies from study to study,and the improvement in symptoms is related to the treatment of SIBO.Conclusion:29.7%of patients with CP have SIBO,the risk is significantly higher than that of non-chronic pancreatitis patients.It is an important reason why some patients with CP can not be relieved.It can be the need for timely diagnosis and treatment of SIBO in clinical CP patients Provide a basis.