Small bowel bacterial overgrowth in subjects living in residential care homes

Objectives: in elderly people, bacterial overgrowth of the small bowel may be occult. The significance of positive breath tests are uncertain: many fi t elderly subjects with positive tests show no evidence of malabsorption. W e assessed the prevalence and significance of bacterial overgrowth in the s mall bowel in a relatively unselected elderly population. Methods: residents of seven elderly people's homes had a glucose hydrogen b reath test. A medical history and anthropomorphic measurements were recorde d. Volunteers with positive breath tests were given doxycycline. After 4 mo nths all volunteers were reassessed. Results: of 140 residents, 62 were tested. Nine (14.5%) had a positive brea th test. There was no difference in anthropomorphic and bowel habit data be tween those with positive and those with negative breath tests. After 4 mon ths of antibiotic treatment, volunteers with a positive breath test had inc reased weight and body mass index, while those with a negative test had dec reased weight and body mass index. Conclusions: the percentage of volunteers with a positive breath test was m uch lower than in previous studies. This may be due to the relatively unsel ected nature of the volunteers. Treatment of bacterial overgrowth resulted in a small bur significant improvement in anthropometric indices. Thtr lack of association of positive breath tests with baseline anthropomorphic meas urements or bowel habit highlights the occult nature of the bacterial overg rowth and questions its clinical importance.