Please note: 2 hour collection
Indications
• Anemia
• Carbohydrate intolerance (Inability to tolerate sweet or starchy foods, fiber, or friendly flora supplements)
• Chronic constipation
• Chronic Fatigue Syndrome (CFS)
• Gastrointestinal distress
• Hypochlorhydria
• Irritable Bowel Syndrome (IBS)
• Leaky gut (Altered intestinal permeability)
• Malabsorption and maldigestion
• Malnutrition and weight loss
• Osteoporosis
• Unexplained abdominal symptoms like pain, especially gas and bloating
Contributing/causal factors
• Adhesions
• Crohn's Disease
• Lymphoma
• Radiation Damage
• Use of acid-blocking drugs
Overview
Overview
This simple, non–invasive, gastrointestinal test detects bacterial overgrowth in the small intestine, often referred to as SIBO.
Normally, far fewer bacteria inhabit the small intestine than the ample growth found in the colon. Gastric acid secretion and intestinal motility keep the small intestine relatively free of bacteria. However, a wide range of abnormalities and malfunctions can encourage bacteria to multiply in the small intestine causing SIBO. The most common causes of SIBO relate to a decrease in the production of hydrochloric acid or pancreatic enzymes, thereby creating an unsterile environment for the small intestine.
Practical
Drinking solution:
Lactulose
2 hour collection
Specimen requirements:
Six fasting breath samples, taken at baseline, 40 minutes, 60 minutes, 90 minutes, and 120 minutes.
Average processing time:
10 ±3 days (Confidence: applies to 90% of tests)
Research
Research
• Bures J, Cyrany J, Kohoutova D, et al. Small intestinal bacterial overgrowth syndrome. 2010;16(24).
• Chedid V, Dhalla S, Clarke JO, et al. Herbal therapy is equivalent to Rifaximin for the treatment of small intestinal bacterial Overgrowth. Global Advances in Health and Medicine. 2014;3(3):16–24.
• Dukowicz AC, Lacy BE, Levine GM. Small intestinal bacterial Overgrowth. 2007;3(2).
• Erdogan A, Rao SSC. Small Intestinal Fungal Overgrowth. Current Gastroenterology Reports. 2015;17(4).
• Fasano A. Leaky gut and autoimmune diseases. Clinical reviews in allergy & immunology. 2011;42(1):71–8.
• Gabbard S, Lacy B, Levine G, Crowell M. The impact of alcohol consumption and cholecystectomy on small intestinal bacterial overgrowth. Digestive diseases and sciences. 2013;59(3):638–44.
• Ghoshal UC, Srivastava D, Ghoshal U, Misra A. Breath tests in the diagnosis of small intestinal bacterial overgrowth in patients with irritable bowel syndrome in comparison with quantitative upper gut aspirate culture. European Journal of Gastroenterology & Hepatology. 2014;26(7):753-760.
• Ghoshal UC. How to Interpret Hydrogen Breath Tests. Journal of Neurogastroenterology and Motility. 2011;17(3):312-317.
• Hauge T, Persson J, Danielsson D. Mucosal bacterial growth in the upper gastrointestinal tract in alcoholics (heavy drinkers). Digestion. 2009;58(6):591–595.
• Lauritano E, Gabrielli M, Scarpellini E, et al. Small intestinal bacterial overgrowth recurrence after antibiotic therapy. The American journal of gastroenterology. 2008;103(8):2031–5.
• Levitt MD. Volume and Composition of Human Intestinal Gas Determined by Means of an Intestinal Washout Technic. New England Journal of Medicine. 1971;284(25):1394-1398.
• Lloyd-Still JD, Shwachman H. Duodenal microflora. The American Journal of Digestive Diseases. 1975;20(8):708-715.
• Methodology and Indications of H2-Breath Testing in Gastrointestinal Diseases: the Rome Consensus Conference. Alimentary Pharmacology & Therapeutics. 2009;29:1-49.
• Newberry C, Tierney A, Pickett-Blakely O. Lactulose Hydrogen Breath Test Result Is Associated with Age and Gender. BioMed Research International. 2016;2016:1-5.
• Rana S, Sharma S, Kaur J, Sinha S, Singh K. Comparison of Lactulose and Glucose Breath Test for Diagnosis of Small Intestinal Bacterial Overgrowth in Patients with Irritable Bowel Syndrome. Digestion. 2012;85(3):243-247.
• Rana SV, Bhardwaj SB. Small intestinal bacterial overgrowth. Scandinavian Journal of Gastroenterology. 2008;43(9):1030-1037.
• Roland B, Ciarleglio M, Clarke J, et al. Small intestinal transit time is delayed in small intestinal bacterial Overgrowth. Journal of clinical gastroenterology. 2014;49(7):571–6.
• Saad RJ, Chey WD. Breath Testing for Small Intestinal Bacterial Overgrowth: Maximizing Test Accuracy. Clinical Gastroenterology and Hepatology. 2014;12(12):1964-1972.