Meta-analysiscited by the Tayebat archiveabstract only checked A-PPI-17 standard review
PPIs and bacterial overgrowth
Proton pump inhibitor use and the risk of small intestinal bacterial overgrowth: a meta-analysis.
Overview
Lo WK et al.. Clin Gastroenterol Hepatol 2013 · PMID 23270866 · DOI 10.1016/j.cgh.2012.12.011
Association found only with the culture test, not with breath tests.
Does the study support the specific claim? Partly · Methodological quality: low
Plain-language summary
Study explained simply
- What did the researchers want to find out?
SIBO risk.
- How was the study done?
Meta-analysis.
- How many people, animals or samples were studied?
3,134.
- What was actually found?
OR 2.28 overall.
- How large was the observed effect?
OR 2.28.
- What do the results mean in everyday life?
Possible overgrowth.
- What are the study's limitations?
Imprecise.
- What does it say about Elawady's specific claim?
Partly supports.
- Do the results apply to Germany and Europe?
Applicable.
- What can explicitly not be concluded from this study?
Clinical relevance.
Scientific in-depth review
1. Full reference
- Authors
- Lo WK, Chan WW
- Journal
- Clin Gastroenterol Hepatol
- Year
- 2013
- Identifier
- PMID 23270866 DOI 10.1016/j.cgh.2012.12.011
- Verification
- verified – PubMed E-utilities efetch, 2026-10-25
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
not stated in abstract
2. Research question
Association between PPI use and SIBO
3. Study design and population
- Study design
- Meta-analysis – Systematic review and meta-analysis
- Population
Adults in 11 studies
- Country
Multinational
- Period
to July 2012
- Sample size
11 studies, 3,134
- Inclusion and exclusion criteria
see abstract
4. Methods and endpoints
- Exposure / intervention
PPI use
- Comparator
Non-use
- Endpoints
SIBO
- Statistical methods
Pooled OR; subgroups by test
5. Actual results
- Results
Pooled OR 2.282 (1.238–4.205); aspirate culture OR 7.587 (1.805–31.894); glucose breath test OR 1.93 (0.69–5.42, n.s.); possible publication bias.
- Absolute risks
not reported in abstract
- Authors' conclusion
PPI use associated with SIBO only when diagnosed by highly accurate test.
6. Strengths
- Diagnostic-method subgroup analysis
7. Weaknesses
- Small studies
- Publication bias
- Test heterogeneity
8. Risk of bias
- Orienting tool
- AMSTAR 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Small, heterogeneous studies.
9. Assessment of the statistical interpretation
See results.
10. Relevance to the specific claim
11. Independent contrary findings
No association with breath testing.
12. Transferability to Germany and Europe
High: European (Swedish, UK, Dutch, German) data show similar associations; PPIs are widely used in Germany.
13. Overall methodological judgement
Plausible but imprecise.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | low |
| Risk of bias | some concerns |
| Precision of results | low |
| Directness | direct |
| Reproducibility | partly replicated |
| Consistency with the overall evidence | mixed |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | essentially correct but incomplete |
14. Open questions
15. Linked fact checks
Use by the Tayebat archive
Note: according to the archive, the studies were compiled by the archive operators. Whether Dr. Elawady himself cited this study is not established.
- What the archive says about the study
Listed in the archive bibliography of the acid-blockers rule without its own interpretation; used implicitly to support the rule summary ('long-term suppression turns against the body: CKD, bacterial overgrowth, C. difficile, pneumonia, B12 and magnesium deficiency, hip fractures, microbiome change, excess mortality').
- A. What was actually studied?
Association between PPI use and SIBO
- B. What did the authors find?
Pooled OR 2.282 (1.238–4.205); aspirate culture OR 7.587 (1.805–31.894); glucose breath test OR 1.93 (0.69–5.42, n.s.); possible publication bias.
- C. What conclusions do the authors themselves draw?
PPI use associated with SIBO only when diagnosed by highly accurate test.
- D. What does the archive derive from it?
Supports 'bacterial overgrowth'.
- E. Is this derivation scientifically justified?
Partly – depends on test.
- Adequacy of the interpretation (by the archive)
- essentially correct but incomplete