SMALL-BOWEL BACTERIAL OVERGROWTH IN PATIENTS WITH ALCOHOLIC CIRRHOSIS

A total of 89 patients with alcoholic cirrhosis and 40 healthy subject s were included in a study to assess the prevalence of intestinal bact erial overgrowth and to analyze its relationship with the severity of liver dysfunction, presence of ascites, and development of spontaneous bacterial peritonitis (SEP). Bacterial overgrowth was measured by mea ns of a breath test after ingestion of glucose. Intestinal bacterial o vergrowth was documented in 27 (30.3%) of the 89 patients with alcohol ic cirrhosis and in none of the healthy subjects. The prevalence of in testinal bacterial overgrowth was significantly higher in cirrhotics w ith ascites (37.1%) than in those with no evidence of ascites (5.3%) a nd among patients with Pugh-Child class C (48.3%) than in patients wit h class A (13.1%) or B (27%). Twelve (17.1%) of the 70 patients with a scites developed an episode of SEP. The prevalence of spontaneous bact erial peritonitis was significantly higher in patients who had intesti nal bacterial overgrowth (30.7%) than in patients who did not (9.09%). We conclude that intestinal bacterial overgrowth occurs in approximat ely one third of patients with cirrhosis secondary to alcohol, particu larly in patients with ascites and advanced liver dysfunction. Moreove r, bacterial overgrowth may be a condition favoring infection of the a scitic fluid.