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Understanding your Results – SIBO

Small levels of bacteria are normally present in the small intestine. Certain acquired conditions may allow excess levels of bacteria to live in the small intestine. When higher levels of bacteria come into the small intestine, they can cause many abdominal symptoms.

Bacteria exposed to sugar forms hydrogen and methane gas. The Gut-chek for small intestinal bacterial overgrowth (SIBO) uses glucose as a detection sugar to see if hydrogen and methane gas forms in the small intestine.

The Gut-chek for SIBO consists of four breath collections. We measure hydrogen, methane and carbon dioxide gas in all four tubes by gas chromatography.

The carbon dioxide gas level allows us to check if (a) the breath sample is valid and (b) normalizes the results in case the breath collection is not perfect.

We compare the hydrogen and methane levels in the 30, 60 and 90 minute breath samples to the baseline (0 minute) sample. If any of the post-glucose samples contain 20 parts per million (ppm) hydrogen gas above the baseline sample, or any methane point of 10 or more, you have bacterial overgrowth of the small intestine.

TEST RESOURCES

SIBO Overview

Instruction Video

Test Preparation

Read Test Instructions

Understanding Your Results

What if I have a Positive SIBO Breath Test?

Conventional and alternative treatment options exist for small intestinal bacterial overgrowth.

Gastroenterologists typically treat SIBO with oral antibiotics. Most physicians use standard doses of oral antibiotics for one to two weeks. Antibiotics do have a short-lived effect and it is very common to need repeated courses of treatment. Doctors are reluctant to do repeated courses of antibiotics due to long-term side effects of antibiotics.

Alternative treatments for bacterial overgrowth include diet, use of natural antibiotics like peppermint oil, and use of probiotics (replacement of harmful with friendly bacteria).

Antibiotics to Treat SIBO

Antibiotic treatment for SIBO is the current therapy used by gastroenterologists. Antibiotics reduce or eliminate the bacterial overgrowth and reverse intestinal inflammation causing malabsorption of nutrients. A variety of antibiotics have been used in the treatment of SIBO including tetracycline, metronidazole, amoxicillin/clavulanate, ciprofloxacin, and doxycycline. More recently, Rifaximin has been shown to be 80% effective in treating SIBO and normalizing hydrogen breath tests.

Limit Foods with High Sugar Levels, Sugar Alcohols and Refined Carbohydrates

Many foods contain high sucrose levels (table sugar), sugar alcohols (sorbitol) or refined carbohydrates (fructose corn syrup and refined flour). Certain strains of bacteria, typically found with SIBO patients, break down sugars and refined carbohydrates. When these bacteria ferment the sugar, they convert them to short-chain fatty acids, creating gas and causing bloating. A popular diet for intestinal problems is the Specific Carbohydrate Diet™ by Elaine Gottschall. The main premise of this diet is complex carbohydrates that are not easily digested, feed harmful bacteria in our intestines causing them to overgrow. The diet starves out these bad bacteria and restores the balance of bacteria in our gut.

Use Natural Substances to Treat SIBO

The most studied natural treatment for small intestinal bacterial overgrowth is enteric coated peppermint oil. Use peppermint oil in a delayed release capsule that doesn’t open until it is in the small intestine. Peppermint oil has been found to kill bacteria in the small intestine. Continue treatment for 1 to 6 months. Other herbal supplements are also useful to treat bacterial overgrowth, such as: Grapefruit seed extract (capsule or liquid form), Oregano oil capsules, Garlic, Berberine, Olive leaf extract

Use Probiotics to Treat SIBO

Take probiotic supplements to enhance the chances of new bacterial colonies to root in the small intestine and eliminate more pathogenic types. Probiotic supplements should include healthy doses (billions of colonies) of lactobacilli and bifidobacteria. Several probiotic products to consider would be Align, Culturelle, VSL #3, and BioGaia.

What if I have a Negative SIBO Breath Test?

You should be relieved that your SIBO breath test was negative. SIBO can be a lifelong problem. If you still are having SIBO like symptoms, you might consider altering your small intestinal bacterial colonies to healthy lactobacilli and bifidobacteria. We would suggest probiotic products such as Align, Culturelle, VSL #3, and BioGaia.

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