Diagnosis of small intestinal bacterial overgrowth in patients with cirrhosis of the liver: poor performance of the glucose breath hydrogen test

Background/Aims: Small intestinal bacterial overgrowth is known to occur in association with cirrhosis of the liver and studies are needed to assess i ts pathophysiological role, The glucose breath hydrogen test as an indirect test for small intestinal bacterial overgrowth has been applied to patient s with cirrhosis but has not yet been validated against quantitative cultur e of jejunal secretion in this particular patient population, Methods: Forty patients with cirrhosis underwent glucose breath hydrogen te st and jejunoscopy. Jejunal secretions were cultivated quantitatively for a erobe and anaerobe microorganisms. Results: Small intestinal bacterial overgrowth was detected by culture of j ejunal aspirates in 73% of patients, being associated with age and the admi nistration of acid-suppressive therapy, The glucose breath hydrogen test co rrelated poorly with culture results, sensitivity and specificity ranging f rom 27%-52% and 36%-80%, respectively, Conclusions: In patients with cirrhosis, the glucose breath hydrogen test c orrelates poorly with the diagnostic gold standard for small intestinal bac terial overgrowth, Until other non-invasive tests have been validated, stud ies addressing the role of small intestinal bacterial overgrowth in patient s with cirrhosis should resort to microbiological culture of jejunal secret ions.