Association of gastroesophageal reflux disease with small intestinal bacterial overgrowth: a case-control study

To explore the potential correlation between alterations in gut microbiota and gastroesophageal reflux disease (GERD) among patients. A case-control study was conducted, involving 50 patients diagnosed with GERD through esophageal pressure measurement and 24-hour dynamic gastric acid monitoring, as well as 53 symptom-matched controls (SCG). All participants underwent Gastrointestinal Symptom Rating Scale (GSRS), Generalized Anxiety Disorder 7-item scale (GAD-7), and Pittsburgh Sleep Quality Index (PSQI) assessments. Methane (CH4) and hydrogen (H2) breath tests were conducted to collect essential clinical data for both groups. Finally, the relationship between small intestinal bacterial overgrowth (SIBO) and GERD was analyzed using Spearman correlation analysis. In the GERD group, GSRS, anxiety rate, and PSQI were all increased (p < 0.001). The positive rate of SIBO in the GERD group is significantly higher than that in the SCG group (p < 0.05). The mean expiratory H2 abundance was significantly higher in the GERD group than in the SCG group. SIBO is positively correlated with GERD and GSRS, and positively correlated with sleep quality and anxiety. GERD is positively correlated with GSRS, and positively correlated with sleep quality and anxiety. The mean expiratory H2 abundance was significantly higher in the GERD group. There may be a potential connection between SIBO and the occurrence of GERD. And SIBO may provide a new perspective on the pathogenesis of GERD.