Testing for SIBO (Small Intestinal Bacterial Overgrowth)

Resource Testing for SIBO (Small Intestinal Bacterial Overgrowth)

Cort

Founder of Health Rising and Phoenix Rising
Staff member
Cort submitted a new resource:

Testing for SIBO (Small Intestinal Bacterial Overgrowth) - Do you have SIBO? Find out if you do....

There is no perfect test for SIBO. The problem is the small intestine; it's too far down the gut for an endoscopy too reach much of it and too far from the other end for a colonoscopy to do the same. A full 17 feet of gut is essentially inaccessible by these tools.

Unfortunately, there is no gold standard for SIBO - no agreed upon criteria and different doctors will interpret the test results differently. A consensus of experts, however, did...
Read more about this resource...
 

dejurgen

Well-Known Member
Hi Cort,

In your resource you wrote:
"Testing

Hydrogen / Methane Breath Test

...The hydrogen sulfide and methane gases..."

Most test do not measure hydrogen sulfide but hydrogen hence the name hydrogen/methane breath test. A wikipedia description is here https://en.wikipedia.org/wiki/Hydrogen_breath_test. It doesn't even mention hydrogen sulfide.

I had the hydrogen/methane breath test about 4 years ago and no problem was detected. It could have been because I was still better, but with what I know now it may well be hydrogen sulfide that was the culprit in my case and that was not tested. I haven't redone the testing since but recently learned I have a severe reaction against fructose.

I also start to suspect that the amount of bacteria in the small intestine does vary a lot with having dhiarea, normal stool or constipation. Dhiarea after all is flushing of the contents of the bowel and that includes its bacterial content. With SIBO frequent oscillating between these states is quite common and might therefore affect test results depending on the state your bowels are currently in.
 

Cort

Founder of Health Rising and Phoenix Rising
Staff member
Hi Cort,

In your resource you wrote:
"Testing

Hydrogen / Methane Breath Test

...The hydrogen sulfide and methane gases..."

Most test do not measure hydrogen sulfide but hydrogen hence the name hydrogen/methane breath test. A wikipedia description is here https://en.wikipedia.org/wiki/Hydrogen_breath_test. It doesn't even mention hydrogen sulfide.

I had the hydrogen/methane breath test about 4 years ago and no problem was detected. It could have been because I was still better, but with what I know now it may well be hydrogen sulfide that was the culprit in my case and that was not tested. I haven't redone the testing since but recently learned I have a severe reaction against fructose.

I also start to suspect that the amount of bacteria in the small intestine does vary a lot with having dhiarea, normal stool or constipation. Dhiarea after all is flushing of the contents of the bowel and that includes its bacterial content. With SIBO frequent oscillating between these states is quite common and might therefore affect test results depending on the state your bowels are currently in.
Hmmm. It's a bit confusing. I got the H2S from somewhere!

This study mentions H2S in connection with the breath test but I wonder if they're writing about a different breath test...

https://www.ncbi.nlm.nih.gov/pubmed/27163246

Here, we show that hydrogen sulphide (H2S) in exhaled breath is distinctly altered for diarrhea-predominant IBS individuals with positive and negative SIBO by the activity of intestinal sulphate-reducing bacteria. Subsequently, by analyzing the excretion kinetics of breath H2S, we found a missing link between breath H2S and SIBO when HBT often fails to diagnose SIBO. Moreover, breath H2S can track the precise evolution of SIBO, even after the eradication of bacterial overgrowth. Our findings suggest that the changes in H2S in the bacterial environment may contribute to the pathogenesis of SIBO and the breath H2S as a potential biomarker for non-invasive, rapid and precise assessment of SIBO without the endoscopy-based microbial culture of jejunal aspirates, and thus may open new perspectives into the pathophysiology of SIBO in IBS subjects.

It looks like that's right. There are two different hydrogen breath tests - one of which is more effective for H2S SIBO. Interestingly that Dr. Siebecker does not mention that.
Hydrogen Sulfide SIBO – When SIBO Tests Are Negative but You Have IBS Symptoms
https://drruscio.com/hydrogen-sulfide-sibo-sibo-tests-negative-ibs-symptoms/
SIBO (small intestinal bacterial overgrowth) often causes the symptoms of IBS: gas, bloating, abdominal pain, constipation, and/or diarrhea. But what do you do if you have IBS-like symptoms but your SIBO test is negative? You may actually have hydrogen sulfide SIBO, which does not show up on standard SIBO breath tests. Let’s discuss exciting news about diagnosing this condition.
 
There is one additional test that helped me figure out the dysbiosis in addition to the breath test, and that is the urine metabolite test, either by Genova Diagnostics or Great Plains Labs.

  • The Great Plains Laboratory
Nutritional and Metabolic Profile (OAT and Amino acids)

  • Genova Diagnostics
NutrEval FMV or ONE (Optimal Nutritional Evaluation) FMV
 

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