Why is testing for SIBO important?
Testing for SIBO is crucial to understand which type of bacteria is present and where it is located in the gastrointestinal (GI) tract. This information is important for determining the most effective treatment options for SIBO, as different types of bacteria require different approaches. In addition to hydrogen, methane-producing bacteria and hydrogen sulfide gas contributes to SIBO and is produced in the small intestine.
This simple, non-invasive, at-home collection test is an essential tool to aid in the proper diagnosis of SIBO. It detects bacteria in the distal end of the small intestine by assessing for hydrogen and methane gas released in the breath. Elevations in these gases confirm the presence of bacteria and aid in developing a more specific treatment plan for their eradication. The treatment duration for SIBO also depends on the severity of the gases seen during testing, which can be detected in both the small and large intestines. These gases, including hydrogen and methane, can diffuse into the bloodstream and cause various symptoms, making accurate GI breath testing essential.
Why Should Someone Retest for SIBO?
Retesting will allow the team to see how the treatment works if symptoms are still present. It will indicate if their SIBO is gone, and if digestive symptoms persist, they may need to focus on other areas of the gut. Retesting is also recommended if the patient is not feeling better after treatment, as diagnostic tests for SIBO can help identify any underlying issues that may be causing the persistence of symptoms, such as celiac disease, inflammatory bowel disease (IBD), abdominal pain, or other conditions.
Hydrogen Methane Breath Test Instructions
Things To Note
Fast for 12 hours before the test.
The test takes 3 hours to complete.
It’s recommended that you take the test in the morning.
Do not insert your finger into the tube sampler – there is a sharp needle.
Preparation
Two weeks before testing: Finish any antibiotics or antifungals. Do not undergo colonoscopy or barium enemas during this time. Regular home enemas like Fleet are fine.
One week before testing: Avoid proton pump inhibitors, also known as PPIs
Four days before testing: Avoid all laxatives, including Vitamin C and Magnesium.
Two days before testing: Refrain from all high-fibre and lactose foods. These foods can ferment in your gut and potentially cause false results.
One day before testing: Implement the prep diet. Only eat the foods approved below.
Baked or broiled meat and fish
Plain, steamed white rice
Eggs
Clear meat broth (no bouillon)
Fats and oils (i.e., coconut oil, olive oil, butter)
Salt and pepper
Weak black coffee and tea
Twelve hours before testing: Begin fasting. Avoid all food/drink and all non-essential medication, except for water.
Day of testing: Wake up one hour before testing. No smoking or exercise before testing.
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Collection Procedure
To prepare for your SIBO testing, lay out the contents of your kit. This should include glass vials, labels, a packet of Lactulose substrate, an EasySampler collection device, bubble wrap sleeves, and a worksheet for recording collection times. If you weigh less than 100 pounds, staple the blue collection bag down to the correct weight. Remember to only consume a solution once you have collected the first baseline breath sample, as instructed by your healthcare provider.
Please note that the next four steps are performed during one single continuous breath for each tube collected.
Take a normal breath in, not a deep breath. This is vital to ensure your breath is not contaminated with room air.
Close your lips around the mouthpiece and exhale normally.
Continue to blow into the mouthpiece to inflate the bag fully. Note that there are two small holes in the blue collection bag. They are intentional. Please do not obstruct these holes. Keep blowing.
While continuing to exhale, completely insert the test tube into the needle holder so that the rubber stopper is punctured. Keep blowing.
After two seconds, pull the tube out of the needle holder and set it aside. Do not stop exhaling until after the tube is removed from the holder. Note that you will not see or hear your breath inside the tube. The tubes have a vacuum that will suck in the exact amount needed for analysis in two seconds. Do not puncture the tube twice.
Immediately after collecting the first baseline breath sample, consume the Lactulose substrate solution. Do not follow the dosage instructions printed on the packet. Instead, mix the entire packet of Lactulose substrate with 8 ounces of water. You must mix the solution within 3-5 minutes. After drinking the solution, collect another breath sample every 20 minutes for 3 hours, using all ten tubes provided. It is important to avoid taking any antacids during this time, as they can affect the accuracy of the test results.
Record the date and time each tube is collected on both the tube labels and the worksheet, and document any symptoms experienced during the test on the worksheet.
When finished, place the tubes in the protective bubble wrap sleeves. Place the protected tubes, worksheet, and any additional paperwork into the box and seal it with the prepaid sticker provided for shipping.
After the lab receives your kit, results will be sent directly to your provider within two weeks.
