Breath Test Interpretation for SIBO

Presenter: Dr Nirala Jacobi BHSc ND
Topics covered:

  • Basics of breath testing
  • Preparation Diet prior to testing
  • Test result interpretation
  • Common patterns
  • Q&A

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Presentation notes

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 = diarrhea 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
Prep Diet
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
  • “Flatlining”
  • Lactulose “non-fermenters”?
  • Normal rise in the large intestine

Re-testing
Treatment – how long?

Any questions, please email us!

Dr Nirala Jacobi BHSc ND
Director, SIBOTest.com

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