The Prevalence of Small Intestinal Bacterial Overgrowth in Primary Biliary Cirrhosis
Bibliographic record
Abstract
Purpose: An alteration of intestinal motility has been documented in cirrhosis in general, predisposing to small intestinal bacterial overgrowth (SIBO). There are scarce data concerning the occurrence of SIBO in primary biliary cirrhosis (PBC). We hypothesize that the prevalence of SIBO is higher in PBC than in cirrhosis due to other etiologies. AIMS: 1) To determine the occurrence of SIBO in patients with PBC. 2) To identify characteristics of patients with SIBO. Methods: Prospective study from 2006 to 2008 at the Saint-Luc Hospital (Montreal, QC, Canada). All participants diagnosed with PBC during the study period had a lactulose hydrogen breath test. Patients were classified as having SIBO if 1 of the following 2 criteria was satisfied: 1) increase in breath hydrogen more than 12 parts per million (ppm) compared to basal production on 2 consecutive measures at 15 minutes intervals before 90 minutes or 2) dual hydrogen peaks (12 ppm increase over baseline with decrease of ≥5 ppm before second peak). In addition, the following parameters were studied: demographic data, digestive clinical symptoms and signs, Child-Pugh and Mayo scores. Results: 52 patients were recruited (50 females, mean age 57±11 years). 36.5 % of patients (n=19) had a test suggestive of SIBO and 63.5% (n=33) had a test considered normal. The patients with SIBO and those without SIBO were similar in terms of age (60.4±10.8 vs. 55.6±13.8; NS), sex and body mass index (25.3±3.5 vs. 24.5±5.1; NS). The following clinical and biological parameters were similar in both groups: presence of abdominal pain or bloating, presence of other related disorders such as scleroderma and celiac disease, transaminases, bilirubin and alkaline phosphatase levels. Diarrhea was less common in the group with SIBO than in the group without SIBO (25% and 64%, respectively, p<0.05). The Mayo severity score of cirrhosis was not different in patients with or without SIBO (4.84±1.42 vs. 5.0±1.28; NS), and most of our patients (50/52) had a Child-Pugh score of A. Conclusion: 36.5% of patients with PBC had a lactulose hydrogen breath test result in favor of SIBO, a proportion higher than what is reported in studies with alcoholic cirrhosis in patients with Child A cirrhosis (17 to 20%). Besides fewer occurrence of diarrhea, no clinical factor was associated with this abnormality. The high occurrence of SIBO in PBC suggests that intestinal transit alterations thus exist in PBC and need to be characterized further.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".