Published online Sep 16, 2022. doi: 10.12998/wjcc.v10.i26.9536
Peer-review started: March 31, 2022
First decision: May 29, 2022
Revised: June 6, 2022
Accepted: August 6, 2022
Article in press: August 6, 2022
Published online: September 16, 2022
Intestinal dysbiosis and small intestinal bacterial overgrowth (SIBO) are common in patients with liver cirrhosis. Existing studies have not explored the association between gut dysbiosis and SIBO. We propose some suggestions for the authors’ experimental methods and concepts, and we hope these suggestions can be adopted. The hydrogen breath test is worthy of recommendation due to its high accuracy and convenient operation. We suggest changing the substrate of the hydrogen breath test from lactulose to glucose to improve the accuracy of each parameter. SIBO is a small subset of gut dysbiosis, and we propose clarifying the concept of both. SIBO may be caused by liver cirrhosis or one of the pathogeneses of gastrointestinal diseases. Therefore, interference from other gastrointestinal diseases should be excluded from this study.
Core Tip: The sensitivity of the hydrogen breath test is higher with glucose than lactulose as the substrate. We recommend using the hydrogen breath test in this experiment for measuring intestinal flora but replacing the test substrate with glucose. We recommend that the authors clarify the relation and concept of small intestinal bacterial overgrowth (SIBO) and gut dysbiosis. When exploring the relationship between gut dysbiosis and SIBO in cirrhosis, the etiology of SIBO should be considered. After estimating the sample size, we determined that the sample size included in the experiment was small and should be expanded.