NEW! All about SIBO Breath Test Interpretation. Webinar with Dr Nirala Jacobi, BHSc, ND (USA) – Medical Director, SIBOTest.com
- Confidently interpret the nuances of hydrogen positive SIBO
- Understand Methane positive SIBO vs IBS-C methane positive
- When to consider hydrogen sulfide on a breath test result
- When to retest your patient
- What do rising hydrogen and falling methane mean on a retest
- Plus Q+A with SIBO expert, Dr Nirala Jacobi
What is breath testing?
- Stool test NOT accurate for SIBO
- Breath test: assess bacterial fermentation over 90-100 minutes measures Methane and Hydrogen gas (not produced by humans)
- SIBO-D = diarrhoea dominant:
- E coli, Klebsiella, Proteus, Aeromonas (most common)
- Produce hydrogen gas (H2)
- SIBO-C = constipation dominant
- Methanobrevibacter smithii produce methane gas (CH4)
Laboratories– how to be
a discerning practitioner
Important questions to ask
- Prep diet – how restrictive?
- open or closed sample collection system
- testing for hydrogen, methane, and CO2
- grams of test sugars
- Sample timing (eg 20 min vs 30 min) and length of test (2h vs 3h)
Prep Guidelines- what to avoid
What test to order?
Interpreting the Results
- Lactulose Test Results- positive
- Lactulose and Glucose Breath Test Positive
- Lactulose negative, Glucose positive
- Methane (CH4) Positive
- Methane conundrum
- Methane positive IBS-C but negative for SIBO
- Methane positive, negative SIBO
- High methane followed by high hydrogen on re-test. Frequently seen- no need for alarm!
- Fructose Positive
- Fructose- timing matters!
- High Baseline
- Bad sampling
- Lactulose “non-fermenters”?
- Normal rise in the large intestine
Treatment – how long?