SIBO - Small Intestinal Bacterial Overgrowth - lactulose or glucose breath test

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small-intestinal-bacterial-overgrowth.jpg
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SIBO - Small Intestinal Bacterial Overgrowth - lactulose or glucose breath test

£204.00

Please note included in the cost of your test is advice, interpretation and support from our functional medicine team on your results.

You will be asked to fill out a patient form at checkout which will give us more information on your symptoms, current medications and supplement intake.

Choose between lactulose or glucose testing. Please note our recommendation is lactulose testing but if you are intolerant to lactose you have the option of glucose testing.

Breath testing for Small Intestinal Bacterial Overgrowth (SIBO), measuring the gut bacterial fermentation products hydrogen and methane, is a robust method of assessing gut microbial activity. Breath gas production within 100 minutes of ingesting carbohydrates is diagnostic of SIBO.

Bacteria in the intestinal tract ferment ingested carbohydrates (lactulose is provided as an oral challenge for this test), gas byproducts pass across the gut wall into the circulation and are rapidly diffused by the lungs and exhaled in the breath.

Ambiguous gut symptoms following ingestion of foods, frequently diagnosed as Irritable Bowel Syndrome (IBS), have been associated with SIBO in up to 75% of these patients. The diagnostic method described here is largely unavailable in NHS gastroenterology departments because it’s considered a labour-intensive procedure for a chronic health condition.

Patients follow a strict low fermentable diet (low fibre, resistant starch, and complex carbohydrates) for 24 hours and fully fast for 12 hours (overnight) prior to the test to minimise normal colonic fermentation. Gas levels in a fasting breath sample are then compared against a subsequent nine samples collected at 20-minute intervals following ingestion of lactulose, a non-absorbable carbohydrate. Increases in breath hydrogen, methane, or both, within the first 100 minutes of the test period are indicative of small intestinal bacterial activity, subsequent gas production reflects normal bacterial activity in the large bowel.

The test results can also be used to assess colonic production of methane gas which occurs naturally in about a third of adults with increasing frequency by age, now formally recognised as Intestinal Methanogen Overgrowth (IMO).

Breath gas determination is also an approved method for the diagnosis of carbohydrate intolerances (specifically lactose and fructose).

Analytes;

  • Breath hydrogen

  • Carbon dioxide

  • Methane gas

  • Turnaround time - approx 7 days. Delivery Available wordwide

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When should I use

Patients with an unresolved diagnosis of IBS, diarrhoea, constipation, postprandial bloating, abdominal discomfort and pain, a history of gastroenteritis, intestinal surgery, Crohn’s disease, coeliac disease, pancreatitis, impaired gut motility or use of proton pump inhibitors (PPIs) are at risk of SIBO and should be considered for screening.

Following a rapid rise in hydrogen levels (within the first 20 minutes) consider possible gastric helicobacter pylori infection.

Sample lactulose report - view HERE

Lactulose instructions - view HERE

Sample glucose report - view HERE

Glucose instructions - view HERE