A PATTERN OF BREATH HYDROGEN EXCRETION SUGGESTING SMALL-BOWEL BACTERIAL OVERGROWTH IN BURMESE VILLAGE CHILDREN

Breath hydrogen tests (BHTs) were performed on 340 Burmese village children aged 1-59 months. Normalization (correction of breath H-2 values to a constant mean O2 level) eliminated the variations in H-2 levels due to sleep, storage temperature, or duration of storage. After a 10 g lactulose test meal, 145 (42.6%) children produced < 10 ppm H-2 above basal values (non-H-2 producers). Of 195 H-2 producers, a pattern of breath hydrogen excretion suggesting small bowel bacterial over-growth (SBBO)-recognized as a transient peak at the 20, 40, or 60 min breath samples following the lactulose test meal and distinguishable from the later colonic peak-was observed in 53 (27.2%), being significantly more frequent in male children, and exhibiting an age-prevalence pattern similar to that of acute childhood diarrhea in these villages. Diarrhea did not alter the state of H-2 production (non-H-2 producers remain non-H-2 producers, and H-2 producers remain H-2 producers) although the magnitude of peak breath H-2 changed.