SIBO Testing - the best way to discover if you have SIBO
It is now possible to test for SIBO with a simple breath test done in the comfort of your own home. You undertake a 24 hour preparatory diet, or 48 hours if constipated. Most people choose to test first thing in the morning, as there’s no food to be consumed 12 hours before the test is conducted. Lactulose is the test substrate and is provided in the test kit. It’s a sugar like drink and so isn’t unpleasant tasting.
Lactulose particles are too large to be absorbed through the gut wall and so it remains in the intestines as a food source for the bacteria, if present, in the small intestine. The bacteria then ferment the lactulose and produce hydrogen, methane or both. These are diffused into the blood stream and exhaled by the breath. The breath samples are taken every 20 minutes for 3 hours. It’s quality controlled using carbon dioxide measurements to make sure the breath samples are done correctly.
Why use Lactulose as the SIBO test substrate?
Glucose is used by some of the labs to test for SIBO as it is another substrate for bacteria. However, it is absorbed in the upper section of the small intestine and so using only glucose means people that have SIBO lower down in their small intestine would be missed. Some of my clients with the biggest turn around of their symptoms have tested positive in the lower section of their small intestine and would have missed out on the treatment and subsequent removal of symptoms had we only used glucose. I’ve been using the lactulose test successfully since 2013 and will continue to do so unless new evidence arises.
A result positive for hydrogen is usually associated with diarrhoea, and methane has been shown to be associated more with constipation. It’s important to know which gas is released at what level by the SIBO for the appropriate treatment strategies to be applied. Note that both of these gases are produced by the bacteria, not by us humans.
The same testing method can be used to test for fructose malabsorption that can be found with severe SIBO. I usually find however that an elimination diet can pick up fructose malabsorption and as reducing fructose is part of the SIBO treatment diet the elimination and reintroduction method is preferred by most clients. If you have severe symptoms testing for fructose malabsorption is available.
Preparation guidelines for the SIBO breath test
It’s important to wait at least 1 month after colonoscopy or Barium studies, as well as after antibiotic use before doing the SIBO test.
The following are to be stopped one week prior to testing:
- Probiotics, yoghurt and Yakult
- Antacids /acid blocking medication (discuss with me if this isn’t possible for you)
- Herbal antimicrobials
- Digestive enzymes or hydrochloric acid supplements or anything that stimulates these
One day before the breath test stop taking:
Instructions for the prep diet come with the test kit.
For many people with IBS symptoms’ getting a positive SIBO test result is a relief. They finally know what’s been causing their symptoms all this time and can start addressing it. See my SIBO treatment page for more information on SIBO treatment plans.
If you’d like to find out more about testing and treatment options for SIBO and IBS or digestive symptoms then please book in for a free nutrition strategy session so I can go over your options.