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Breath-hydrogen test for small-intestinal bacterial colonisation

G Metz, M A Gassull, B S Drasar

    Lancet (London, England)
    |March 27, 1976
    PubMed
    Summary
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    The breath-hydrogen test and the 14C-glycine-cholate breath test can help diagnose small intestinal bacterial overgrowth. Combining these tests improves diagnostic accuracy for bacterial colonization in the small intestine.

    Area of Science:

    • Gastroenterology
    • Diagnostic Medicine
    • Microbiology

    Background:

    • Small intestinal bacterial overgrowth (SIBO) is a condition where bacteria proliferate in the small intestine.
    • Accurate diagnosis of SIBO is crucial for effective treatment.
    • Current diagnostic methods have limitations in sensitivity and specificity.

    Purpose of the Study:

    • To evaluate the diagnostic performance of the breath-hydrogen test for small intestinal colonization.
    • To compare the breath-hydrogen test with the 14C-glycine-cholate breath test and bacteriological examination.
    • To assess the combined utility of these breath tests in diagnosing SIBO.

    Main Methods:

    • 17 patients suspected of SIBO underwent oral glucose administration for breath-hydrogen testing.

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  • Results were compared with the 14C-glycine-cholate breath test and direct bacteriological examination of small intestinal aspirates.
  • Sensitivity and specificity of each test and their combination were analyzed.

    • Main Results:

    • Bacteriological examination confirmed SIBO in 12 out of 17 patients.
    • Both breath tests independently identified 8 out of 12 colonized patients.
    • Concordant positive results were observed in 5 patients; however, using both tests missed only 1 case of SIBO.
    • The breath-hydrogen test showed no false-positive results in bacteriologically normal individuals.

    Conclusions:

    • The breath-hydrogen test is a reliable method for detecting small intestinal colonization.
    • Simultaneous application of the breath-hydrogen test and the 14C-glycine-cholate breath test enhances the indirect diagnosis of SIBO.
    • Combining these non-invasive breath tests offers improved accuracy and reduced missed diagnoses for SIBO.