Small Intestinal Bacterial Overgrowth and Orocecal Transit Time in Patients of Nonalcoholic Fatty Liver Disease

Abstract Background: To explore the frequency of small intestinal bacterial overgrowth (SIBO) and orocecal transit time (OCTT) in patients with nonalcoholic fatty liver disease (NAFLD). Methods: 103 patients with NAFLD and 49 healthy controls were enrolled. Clinical indicators such as body mass index (BMI), liver function, blood lipids, HOMA-IR, serum endotoxin of NAFLD patients were collected and examined. Fibro Touch was used to detect the (controlled attenuation parameter) CAP and liver stiffness measurement (LSM). SIBO and OCTT were measured by lactulose hydrogen breath test. Results: The incidence of SIBO in NAFLD patients (58.3%) was significantly higher than that in healthy controls (26.5%). The level of serum endotoxin in NAFLD patients was higher than that in healthy controls. The levels of CAP, LSM, serum endotoxin, ALT, AST and HOMA-IR in SBIO-positive NAFLD patients were higher than those in SIBO-negative patients. There was no significant difference in GGT, TG, LDL and BMI between the two groups. OCTT in NAFLD patients was longer than that in healthy controls. It was also observed that OCTT in SIBO-positive NAFLD patients was significantly delayed compared with SIBO-negative NAFLD patients. Conclusions: Patients with NAFLD exhibit the increased incidence rate of SIBO and prolonged OCTT; SIBO in NAFLD patients is a contributing factor to the elevated transaminase, hepatic steatosis, progression of liver fibrosis and prolonged OCTT.