SIBO Breath hydrogen & methane - small intestinal bacterial overgrowth

anatomy intestines low res.jpg
anatomy intestines low res.jpg

SIBO Breath hydrogen & methane - small intestinal bacterial overgrowth


3 hour Lactulose breath test for hydrogen and methane to test for gut fermentation indicative of Small Intestine Bacterial Overgrowth (SIBO)

Sample: breath

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Sample: breath
Turnaround time: 7-10 days
Location: home or BIolab
Biolab datasheet
Sample report

SIBO stands for Small Intestine Bacterial Overgrowth.  Our gut bacteria predominantly lives in the large intestine (colon) but as the name suggests, SIBO describes a situation where bacteria has built up within the small intestine.  The bacteria is not ‘pathogenic’, there is just too many of them living in the wrong part of the digestive system.  This means the bacteria can start to ferment our food before we’ve had time to properly digest and absorb the nutrients.  Fermentation in the small intestine leads to a range of symptoms. 

The most common symptoms of SIBO:

-   Bloating, wind, burping
-   IBS
-   Constipation and/or diarrhoea (depending on the microbes present)
-   GERD – reflux/heartburn
-   Food reactions, GI symptoms or leaky gut
-   Nausea, indigestion
-   Systemic – depression, anxiety, fatigue, brain fog
-   Issues with weight loss or weight gain

How common is it?
Research suggests that around 60% of Irritable Bowel Syndrome (IBS) cases are linked to SIBO (1,2).  Therefore, when investigating IBS, it is worth checking for SIBO to either confirm or rule it out as an underlying cause.

Gut-Brain Axis
SIBO is starting to be understood as one of the many ways the gut environment may be impacting the brain, mood and mental health. Research has shown that SIBO can be a cause of anxiety, depression and brain fog (3) and eradicating the bacteria can lead to reduction in symptoms (4).

Food Poisoning / Travel Bugs
Research shows that many cases of SIBO develop either immediately or within 6 months of a notable bout of gastritis, food poisoning or travellers diarrhoea.  It has been found that certain toxins released by pathogenic bacteria can lead to permanent damage of the signalling mechanisms which take care of small intestine motility, leading to SIBO.   While not always the case, SIBO triggered by gastritis often requires on-going care as the motility mechanism is permanently dysfunctional.

Although ‘post-infective IBS’ may directly follow a case of gastroenteritis, in many cases, it can take up to 6 months for SIBO and related symptoms to develop after the infection has cleared.

Hydrogen or methane?
SIBO is often referred to as hydrogen or methane dominant.  This describes which gas is one being produced at higher levels by your gut microbiome.  Hydrogen is slightly more common and is usually experienced with bloating, cramps, loose stools.  On the other hand, methane SIBO leads to more to symptoms of bloating and persistent constipation.  This is because methane is a signalling chemical which slows gut motility down.

Detailed instructions will be provided with the kit.

A strict diet (outlined below) must be followed the day before doing this test.
A 14 hour overnight fast is required before starting the test (water is fine).
The first breath test is taken at the start of the test
Lactulose solution is consumed.
Breath samples are collected every 20 minutes for 3 hours.

Pre-test diet
All 'slow digesting' foods and foods containing fibre must be avoided the day before the test as any residual fibre can give false fermentation results.
Foods allowed: 
concentrated protein (egg, chicken, fish)
low fibre carbohydrate (white rice)