SIBO Quiz: How Well Do You Understand SIBO?

How SIBO Savvy Are You?

Designed for patients and health practitioners, this quiz is designed for education only and is not intended to diagnose or treat any condition.

This quiz explores the nuances of SIBO diagnosis and treatment — from breath testing and risk factors to long-term management. Whether you’re a patient or a practitioner, you may be surprised by how complex gut diagnosis truly is.

SIBO is best described as

An overgrowth of normal commensals in the small intestine.

An overgrowth of pathogenic bacteria in the small intestine.

An overgrowth of pathogenic organisms in the large intestine.

An overgrowth of normal commensals in the large intestine.

Common risk factors for SIBO include all of the following, except:

Gout

Food poisoning

Diabetes

Abdominal surgery

The following is NOT considered to be a causative factor for SIBO:

Restless leg syndrome

An impaired migrating motor complex

Deficient hydrochloric acid

Abdominal adhesions

Hydrogen and methane breath testing for patients with IBS symptoms:

Is not necessary, the practitioner should be guided by symptoms alone.

Used to see if the patient has SIFO (small intestinal fungal overgrowth).

Knowing if hydrogen or methane are dominant will help diagnose SIBO and guide treatment for the practitioner.

Can also be used to diagnose parasitic infections.

The following is true about a positive lactulose breath test:

Hydrogen will rise by 12ppm by 90-100min.

Any rise of hydrogen is considered positive.

Hydrogen will rise by 20ppm by 90-100min.

In the absence of hydrogen, methane must rise by 20ppm.

SIBO-C (constipation dominant SIBO) is:

Usually easier to treat

Usually caused by Klebsiella pneumoniae

Usually caused by methanogens producing methane

Diagnosed by a rise in hydrogen on a breath test

SIFO (small intestinal fungal overgrowth) is:

Commonly present with SIBO.

Rarely present with SIBO.

Usually responsive to standard antibacterial antibiotics.

Easily distinguished from SIBO because it presents with completely different symptoms.

The Elemental diet:

Is an antimicrobial treatment on par with antibiotics or herbal antimicrobials

Is used as a maintenance diet to prevent SIBO relapse

Is best suggested alongside herbal or conventional treatment

Is a fibre-rich diet

Treatment for SIBO can include:

Rifaximin

Berberine containing herbs

Prokinetics

All of these

SIBO is often a chronic relapsing condition, and:

Patients should remain on antibiotics long term

Prokinetics may have to be used long term

Prokinetics should not be used long term

If some of these questions felt challenging, that’s completely normal.
SIBO diagnosis and treatment are genuinely complex, and understanding them often requires education, testing, and professional interpretation.

Get a copy of the SIBO Savvy Quiz
Enter your email to receive the full quiz questions, correct answers, and explanations, so you can revisit what you’ve learned anytime. We’ll only use your email to send your quiz results and relevant educational resources.

This quiz is intended to support learning — not replace personalised medical care.