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Evaluation of the rice breath hydrogen test for small intestinal bacterial overgrowth.
Am J Gastroenterol 2000; 95(10):2858-64AJ

Abstract

OBJECTIVES

The aims of this study were 1) to document the sensitivity, specificity, and predictive values of the rice breath hydrogen test for small intestinal bacterial overgrowth; 2) to determine the possible influence of concurrent gastric bacterial overgrowth and gastroduodenal pH on the efficacy of this test; and 3) to investigate whether reliability is limited by an inability of small intestinal luminal flora to ferment rice or its product of hydrolysis, maltose.

METHODS

Twenty adult subjects were investigated with microbiological culture of proximal small intestinal aspirate and a 3-g/kg rice breath hydrogen test. Gastroduodenal pH, the presence or absence of gastric bacterial overgrowth, and the in vitro capability of small intestinal luminal flora to ferment rice and maltose, its product of hydrolysis, were determined.

RESULTS

Sensitivity of the rice breath hydrogen test for small intestinal bacterial overgrowth was 33% and remained low even when subjects with small intestinal overgrowth with oropharyngeal-type (38%) and colonic-type flora (20%) and those with concurrent small intestinal and gastric bacterial overgrowth (40%) were considered separately. Sensitivity remained suboptimal despite favorable gastroduodenal luminal pH and documented ability of bacterial isolates to ferment rice and maltose in vitro. Specificity of the rice breath hydrogen test for small intestinal bacterial overgrowth was 91%. Positive predictive value, negative predictive value, and predictive accuracy were 75%, 63%, and 65%, respectively.

CONCLUSIONS

Clinical value of the rice breath hydrogen test for detecting small intestinal bacterial overgrowth is limited. The rice breath hydrogen test is not a suitable alternative to small intestinal intubation and culture of secretions for the detection of small intestinal bacterial overgrowth.

Authors+Show Affiliations

Department of Gastroenterology, The Prince of Wales Hospital, Randwick, NSW, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Studies
Journal Article

Language

eng

PubMed ID

11051360

Citation

Riordan, S M., et al. "Evaluation of the Rice Breath Hydrogen Test for Small Intestinal Bacterial Overgrowth." The American Journal of Gastroenterology, vol. 95, no. 10, 2000, pp. 2858-64.
Riordan SM, McIver CJ, Duncombe VM, et al. Evaluation of the rice breath hydrogen test for small intestinal bacterial overgrowth. Am J Gastroenterol. 2000;95(10):2858-64.
Riordan, S. M., McIver, C. J., Duncombe, V. M., Thomas, M. C., & Bolin, T. D. (2000). Evaluation of the rice breath hydrogen test for small intestinal bacterial overgrowth. The American Journal of Gastroenterology, 95(10), pp. 2858-64.
Riordan SM, et al. Evaluation of the Rice Breath Hydrogen Test for Small Intestinal Bacterial Overgrowth. Am J Gastroenterol. 2000;95(10):2858-64. PubMed PMID: 11051360.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of the rice breath hydrogen test for small intestinal bacterial overgrowth. AU - Riordan,S M, AU - McIver,C J, AU - Duncombe,V M, AU - Thomas,M C, AU - Bolin,T D, PY - 2000/10/29/pubmed PY - 2001/2/28/medline PY - 2000/10/29/entrez SP - 2858 EP - 64 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 95 IS - 10 N2 - OBJECTIVES: The aims of this study were 1) to document the sensitivity, specificity, and predictive values of the rice breath hydrogen test for small intestinal bacterial overgrowth; 2) to determine the possible influence of concurrent gastric bacterial overgrowth and gastroduodenal pH on the efficacy of this test; and 3) to investigate whether reliability is limited by an inability of small intestinal luminal flora to ferment rice or its product of hydrolysis, maltose. METHODS: Twenty adult subjects were investigated with microbiological culture of proximal small intestinal aspirate and a 3-g/kg rice breath hydrogen test. Gastroduodenal pH, the presence or absence of gastric bacterial overgrowth, and the in vitro capability of small intestinal luminal flora to ferment rice and maltose, its product of hydrolysis, were determined. RESULTS: Sensitivity of the rice breath hydrogen test for small intestinal bacterial overgrowth was 33% and remained low even when subjects with small intestinal overgrowth with oropharyngeal-type (38%) and colonic-type flora (20%) and those with concurrent small intestinal and gastric bacterial overgrowth (40%) were considered separately. Sensitivity remained suboptimal despite favorable gastroduodenal luminal pH and documented ability of bacterial isolates to ferment rice and maltose in vitro. Specificity of the rice breath hydrogen test for small intestinal bacterial overgrowth was 91%. Positive predictive value, negative predictive value, and predictive accuracy were 75%, 63%, and 65%, respectively. CONCLUSIONS: Clinical value of the rice breath hydrogen test for detecting small intestinal bacterial overgrowth is limited. The rice breath hydrogen test is not a suitable alternative to small intestinal intubation and culture of secretions for the detection of small intestinal bacterial overgrowth. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/11051360/Evaluation_of_the_rice_breath_hydrogen_test_for_small_intestinal_bacterial_overgrowth_ L2 - http://Insights.ovid.com/pubmed?pmid=11051360 DB - PRIME DP - Unbound Medicine ER -