OBJECTIVES Small intestinal bacterial overgrowth (SIBO) can complicate chronic pancreatitis (CP) and interfere with management. Its predisposing factors in CP and treatment response are unknown. In this review, we evaluated factors affecting disease burden. METHODS A computerized search of PubMed and EMBASE databases from inception through May 2019 was done for studies correlating SIBO with CP. Studies were screened, and relevant data were extracted and analyzed. Pooled prevalence, odds ratio (OR), and meta-regression were performed using the random effects model as classically described by Borenstein et al. (2009). SIBO's relation to diabetes mellitus (DM), pancreatic exocrine insufficiency (PEI), narcotic use, and proton-pump inhibitor use was investigated. Treatment response was pooled across studies. P value < 0.05 was considered significant. RESULTS In 13 studies containing 518 patients with CP, SIBO prevalence was 38.6% (95% confidence interval [CI] 25.5-53.5). OR for SIBO in CP vs controls was 5.58 (95% CI 2.26-13.75). Meta-regression showed that PEI and the diagnostic test used were able to explain 54% and 43% of the variance in SIBO prevalence across studies, respectively. DM and PEI were associated with increased SIBO in CP with OR (2.1, 95% CI 1.2-3.5) and OR (2.5, 95% CI 1.3-4.8), respectively. Symptomatic improvement was reported in 76% of patients after SIBO treatment. DISCUSSION SIBO complicates 38% of CP with OR of 5.58 indicating a predisposition for this condition. PEI correlates with SIBO in CP and might play a role in pathophysiology. DM and PEI are associated with increased SIBO in CP. Treatment of SIBO may lead to symptomatic improvement.

中文翻译：

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在慢性胰腺炎中影响小肠细菌过度生长的因素：系统评价，荟萃分析和荟萃回归。

目的小肠细菌过度生长（SIBO）可使慢性胰腺炎（CP）复杂化并干扰管理。其在CP和治疗反应中的诱发因素尚不清楚。在这篇综述中，我们评估了影响疾病负担的因素。方法从开始到2019年5月，对PubMed和EMBASE数据库进行了计算机搜索，以研究SIBO与CP的相关性。筛选研究，并提取和分析相关数据。使用Borenstein等人经典描述的随机效应模型进行合并患病率，比值比（OR）和元回归。（2009）。研究了SIBO与糖尿病（DM），胰腺外分泌功能不全（PEI），麻醉剂使用和质子泵抑制剂使用的关系。在所有研究中汇总了治疗反应。P值<0。05被认为是重要的。结果在包含518名CP患者的13项研究中，SIBO患病率为38.6％（95％置信区间[CI] 25.5-53.5）。CP与对照组相比，SIBO的OR为5.58（95％CI 2.26-13.75）。荟萃回归显示，PEI和诊断测试分别能够解释整个研究中SIBO患病率的54％和43％。DM和PEI与CP的SIBO升高相关，分别为OR（2.1，95％CI 1.2-3.5）和OR（2.5，95％CI 1.3-4.8）。在SIBO治疗后，有76％的患者出现症状改善。讨论SIBO使38％的CP复杂化，OR为5.58，表明该病的易感性。PEI与CP中的SIBO相关，并可能在病理生理中起作用。DM和PEI与CP的SIBO增加有关。