Volume 47, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Breath hydrogen tests were performed after a rice meal (3 g of cooked rice/kg of body weight, equivalent to 1 g of carbohydrate/kg of body weight) on 256 village children (age range 1–59 months) who were known hydrogen (H) producers. Anthropometric measurements were made every three months and growth rates were calculated. A breath H excretion pattern that suggested small bowel bacterial overgrowth (SBBO), which was recognized as a transient maximum level of 10 ppm or more at 20-, 40-, or 60-min breath samples following the rice meal, was present in 53 (20.7%) children, and was more frequent in children 36–47 and 48–59 months old. This breath H excretion pattern was detected in 48 (33.3%) of 144 children who were rice malabsorbers (> 10 ppm H above baseline values in one of the breath samples taken between 90 and 240 min), and in only five (4.5%) of 112 rice absorbers. Children who had SBBO had a high relative risk (10.7) of being rice malabsorbers. Rice malabsorbers have a high relative risk (59.7) of having faltered growth, accompanied by a large etiologic fraction (94%). This same risk (6.68) and an etiologic fraction of 62% exist in children with untreated SBBO. These findings emphasize the need for interventions aimed at reducing the prevalence of SBBO or similar conditions as detected by the breath H excretion pattern to prevent rice malabsorption and growth faltering.


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