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Hydrogen Breath Testing for SIBO

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Crohn's Disease
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Posted 1/9/2011 4:54 AM (GMT 0)
Hi -

I do not have Chron's, but rather, was dx'd in 2005 with IBS-D.

I'm your typical case: nothing has ever provided relief and I'm not on any rx meds at the moment. I try to control symptoms through diet, exercise, probiotics, and OTC meds like Imodium. My predominant symptoms are excessive, uncontrollable, foul smelling gas, abdominal distension, abdominal discomfort and pain. These symptoms seem to worsen considerably every time I eat, no matter what I eat.

I have an appointment in a couple weeks with a new GI Doc at Cedars Sinai and was told that I will probably be sent to have a hydrogen breath test to test for SIBO. I'm happy to have the test as a cursory reading about SIBO in medical articles and elsewhere on the web makes me think there is a strong likelihood I may have it too, especially given that I experienced long lasting almost complete "remission" of my IBS after taking a course of Cipro a couple years back when traveling abroad.

After searching on here, I saw more discussions re SIBO in the Chrohn's forum than on the IBS forum, so I am posting here.

I am just curious, for that have undergone the test, what is the test like? Does it truly take 3 hours and where you do have to take it? Home or at a lab? How quickly do they get the test results back?

Thank you in advance!
Posted 1/9/2011 9:08 AM (GMT 0)
Hi there

Tests are done at a lab or in my case my dieticians offices. You drink a solution of lactulose syrup. For the next three hours, breath samples are taken at 15-minute intervals. Any bacteria present in the small intestine will eat the lactulose and then digest it. The digestion process produces various different types of gas, and of these, hydrogen and methane are detectable in the breath and can be measured. The levels of these gases are then used to estimate the numbers of bacteria present. The levels of gas may also correspond with the type of IBS present, as constipation sufferers tend to have higher levels of methane.

If you do not have bacteria in the small intestine, it will take around two hours before the lactulose reaches the bacteria in the colon which are present even in healthy people. Therefore, if the levels of gases rise after only a short time, and in high concentrations, it shows that bacteria are probably present in the small intestine.

You sound like a good candidate for FODMAP :)

http://www.mecfs-vic.org.au/sites/www.mecfs-vic.org.au/files/Article-BarrettPractGastro.pdf
Posted 1/9/2011 5:30 PM (GMT 0)
Funny you should say that, as I found the FODMAP diet a few weeks ago. In reading through it, I found it interesting that I pretty much already "followed" it. I had already eliminated nearly all the trouble/trigger foods listed on FODMAP through about 10 years of simple trial and error on my own. Low sugar, low carb definitely reduces my symptoms a little bit. The biggest change I've made after reading it, however, is cutting nearly all wheat out of my diet. I am replacing wheat products with rice and quinoa. I think it helps a little bit, too.

Thanks for the info re the test! One more question : this lactulose drink that you take...does it trigger symptoms (e.g. gas, diarrhea, stomach pain)? I imagine something that they give to feed the problematic bacteria would trigger symptoms, too. Just curious...
Posted 1/9/2011 5:42 PM (GMT 0)
it made me poo alot!
Posted 1/9/2011 6:53 PM (GMT 0)
Have you been tested for celiac? It is recommended for ppl with IBS.
Posted 1/9/2011 6:54 PM (GMT 0)
Uh oh...I was afraid of that :/
Posted 1/9/2011 6:55 PM (GMT 0)
@ Roni - Yes, I've been tested a few times for celiac actually. All tests came back negative. I've had every test imaginable done, except for the breath test. For some reason, my former GI never did it.
Posted 1/9/2011 7:15 PM (GMT 0)
I have had SIBO a few times. I have never done the testing, my doc just diagnosed me by symptoms. My symptoms were alot of gas and bloating especially after eating, then from the gas pressure I would get alot of discomfort/pain in my abdomen. Another clue was very soft and sticky stools. Hope that helps.
Posted 1/9/2011 8:10 PM (GMT 0)
Thanks, Nanners. Your symptoms sound exactly like mine. I'm not sure whether this doctor would prescribe the medication absent the breath test..that thought hadn't really crossed my mind. I guess I'll wait and see what happens at my visit.

You said you've had SIBO a few times. Did it recur after the antibiotics? If so, how long after was the recurrence? Do you take probiotics too? Thanks!
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