SIBO Breath Test: Why It’s Done, How it Works, the Results (2024)

The small intestinal bacterial overgrowth (SIBO) breath test is a noninvasive test that measures the amount of gases produced by bacteria in the small intestine.

Small intestinal bacterial overgrowth (SIBO) is a condition characterized by excessive bacteria in the small intestines leading to gut-related symptoms like bloating, diarrhea, and abdominal pain. While SIBO is not usually life threatening, it can significantly impact a person’s quality of life and make daily activities difficult.

The SIBO breath test involves consuming a sugar solution and then measuring the levels of hydrogen and methane in the breath at specific intervals. Having higher levels of these gases may indicate that a person has SIBO.

This article will give you an overview of the SIBO breath test, including what it is, how it works, what to expect before and during the test, and more.

Your doctor may use this breath test to detect the presence of excess bacteria in the small intestine (SIBO) or if they suspect you are intolerant to a certain type of sugar.

A doctor may order a SIBO breath test if you have symptoms of small intestinal bacterial overgrowth (SIBO), including:

  • bloating
  • abdominal pain
  • diarrhea
  • nausea or vomiting
  • unintentional weight loss
  • malabsorption of nutrients

They may also recommend this test if you have had abdominal surgery or have any of the following conditions that can lead to SIBO:

  • inflammatory bowel disease (IBD), like Crohn’s disease
  • celiac disease
  • hypochlorhydria (low stomach acid)
  • sugar intolerance
  • gastroparesis (delayed stomach emptying)
  • diabetes
  • small bowel diverticula (a group of conditions that affect the digestive tract)

A SIBO breath test can be performed at a medical facility or at home, depending on the type of test being used.

SIBO breath test at home

At-home SIBO breath test kits are available both over the counter and with a prescription, depending on the kit. Over-the-counter kits can cost anywhere from $100 to $300, while prescription kits may be covered by medical insurance or government benefits, depending on your specific plan.

You should consider this type of test if you are unable to visit a doctor’s office or if you have mild to moderate symptoms of SIBO and have not previously been diagnosed or treated for the condition.

At a medical facility

You should consider taking the SIBO breath test at a medical facility if you have a history of gastrointestinal disorders or have previously received treatment for SIBO. The cost of this type of test can vary depending on the medical facility and your insurance plan, but it’s generally covered by medical insurance or government benefits.

The steps involved in the test may vary depending on whether you are taking an at-home test or having the test performed at a medical facility.

Before the test

Your doctor will give you instructions. They may advise you to follow a specific diet in the days leading up to the test. This can include avoiding foods or drinks containing high fiber, a lot of sugar, or alcohol because they can affect the results of the test.

You may also be advised to fast for 8 to 12 hours before the test. Your doctor will confirm with you when you should stop eating and drinking.

Additionally, you should refrain from certain medications like antibiotics or supplements that may affect the test outcomes. Consider speaking with your doctor before stopping any medications, as they may need to adjust your treatment plan or provide alternative medications.

During the test

At home

Your doctor will provide you with a kit that includes a sugar solution and a device for collecting breath samples.

  1. First, you will consume the sugar solution provided in the test kit.
  2. Collect breath samples at specific intervals using the collection tubes provided.
  3. Once done, you will return the collected samples to the laboratory or your doctor for analysis.

At a facility

  1. When you arrive, your doctor will collect a baseline breath sample before the test begins to establish your baseline level of hydrogen and methane.
  2. They will then provide you with a sugar solution to consume. The sugar solution contains a specific type of sugar that the bacteria in the small intestine can ferment, producing hydrogen or methane gas.
  3. Your doctor will collect breath samples at specific intervals, usually every 15 to 20 minutes for up to 3 hours.
  4. The collected breath samples will be analyzed in a laboratory.

Some of the results you may receive after a SIBO breath test include:

  • Positive results: A rise in hydrogen gas of 20 parts per million (ppm), or 10 ppm in methane gas, above the baseline level in your breath within the first 2 hours of the test may indicate SIBO.
  • Negative results: No significant overgrowth of bacteria in the small intestine was discovered.

Some alternative tests for SIBO may include:

  • Stool testing: It’s less invasive than the breath test and can be used to detect SIBO by examining the levels of certain bacterial markers in your stool.
  • Intestinal biopsy: A biopsy is more invasive than a breath test and is typically reserved for cases where other tests have been inconclusive.
  • Serum antibody testing: This test is less invasive than the breath test, and it measures levels of antibodies against certain types of bacteria, which can indicate bacterial overgrowth in the small intestine.

Here are some frequently asked questions about SIBO breath tests:

Can a breath test detect SIBO?

Yes, a breath test can detect SIBO. It involves drinking a sugar solution and measuring the levels of hydrogen and methane gases in the breath over a set period.

How accurate is the breath test for SIBO?

The breath test is considered a reliable method for detecting SIBO, with a sensitivity and specificity of over 80%.

What does a SIBO breath test cost?

At-home test kits can cost anywhere from $100 to $300, while in-office tests can vary depending on the medical facility and your insurance plan.

What medications should you avoid before a SIBO breath test?

You should avoid medications that can interfere with the gut microbiota or the metabolism of the sugar solution, such as antibiotics, probiotics, antacids, and laxatives.

What does a positive SIBO breath test mean?

A positive SIBO breath test means an overgrowth of bacteria in the small intestine, which can lead to various gut-related symptoms.

A SIBO breath test is a noninvasive test used to identify the presence of small intestinal bacterial overgrowth (SIBO), a condition that can cause a variety of gut-related symptoms. This test can be performed at home or in a medical facility. Before this test, your doctor will give you instructions to follow regarding medication use, dietary restrictions, and other preparations to ensure the accuracy of the results.

SIBO Breath Test: Why It’s Done, How it Works, the Results (2024)

FAQs

SIBO Breath Test: Why It’s Done, How it Works, the Results? ›

Common tests include: Breath testing. This type of noninvasive test measures the amount of hydrogen or methane that you breathe out after drinking a mixture of glucose and water. A rapid rise in exhaled hydrogen or methane may indicate bacterial overgrowth in your small intestine.

How to interpret sibo test results? ›

A rise of ≥ 20 ppm from baseline in hydrogen by 90 min should be considered a positive test to suggest the presence of SIBO. A peak methane level ≥ 10 ppm at any point is indicative of a methane-positive result.

How does the SIBO breath test work? ›

The SIBO breath test involves consuming a sugar solution and then measuring the levels of hydrogen and methane in the breath at specific intervals. Having higher levels of these gases may indicate that a person has SIBO.

How accurate is the breath test for SIBO? ›

A recent meta-analysis cited a sensitivity of 42% and specificity of 70.6% for the lactulose breath test compared with a sensitivity of 54.5% and specificity of 83.2% for the glucose breath test.

What do the results of a breath test mean? ›

If the breath test results in high levels of hydrogen, it means that sugar wasn't well digested in your intestines. Glucose is the preferred sugar to test for small intestinal bacterial overgrowth (SIBO). That's because glucose is usually very quickly absorbed in your small intestine.

What kills SIBO naturally? ›

Some herbs that are commonly used in the treatment of SIBO include:
  • Berberine. Berberine is a compound that is derived from plants, including Oregaon grape, phellodendron and goldenseal. ...
  • Oil of Oregano. Oregano oil contains compounds that have been shown to have antimicrobial properties and can be helpful in SIBO.
  • Garlic.
Aug 8, 2023

How do I know if I have hydrogen or methane SIBO? ›

People with methane SIBO often present with constipation and people with hydrogen SIBO often present with diarrhea but it isn't a sure thing.

What is the root cause of SIBO? ›

The actual prevalence of small intestinal bacterial overgrowth is vastly unknown. Irritable bowel syndrome, intestinal motility disorders, and chronic pancreatitis are the most predominant cause of SIBO and account for 80-90% of cases.

Why does the SIBO test take 3 hours? ›

Clinicians have the option of a 2-hour or 3-hour SIBO assessment. The 3-hour SIBO profile is designed to offer a comprehensive view of gas levels over a prolonged duration. This extended testing period is particularly recommended for patients who experience slower gastrointestinal transit or suffer from constipation.

Where is SIBO Pain located? ›

Abdominal pain – linked to the bloating, as the gases build up in the small intestine, they stretch the intestinal walls, and this can be very painful. In some people this pain can be crippling, really affecting their ability to perform ordinary daily tasks.

What if I messed up my SIBO test? ›

If you somehow messed up the first test tube, and you have not begun to drink the lactulose solution, just discard the messed up tube and start a new one. Write on the patient record what happened and skip the 10th tube in the kit. The last tube is less important than the first few.

Can you have a SIBO with a negative breath test? ›

Breath tests often target the upper part of the small intestine, but the overgrowth may be in the lower parts. This can lead to false negatives, as the bacteria causing SIBO may not reach the testing site.

What does a positive SIBO breath test look like? ›

In an individual with SIBO, there will be a rise of hydrogen gas within the first 90 minutes of the study. A rise in hydrogen during this period doesn't mean an automatic SIBO diagnosis as the natural low level of bacteria in the small intestine will produce low levels of hydrogen.

What is a fail on a breath test? ›

Failing a breathalyzer test means that you are over the legal limit for your blood alcohol content (BAC) and criminal prosecution will ensue. The following talks about the accuracy of breathalyzer tests and your defense against these seemingly infallible results.

What does SIBO gas smell like? ›

Hydrogen Sulfide Dominant SIBO

This type of SIBO occurs when bacteria in the small intestine consume the hydrogen gas made by other bacteria to produce hydrogen sulfide, the gas that smells like rotten eggs.

How do you treat a positive Sibo test? ›

There are a variety of antibiotics that your doctor may recommend to treat SIBO, including rifaximin, neomycin, metronidazole, amoxicillin-clavulanate, ciprofloxacin, and trimethoprim-sulfamethoxazole.

What is considered a positive SIBO test? ›

Therefore, to get a positive SIBO diagnosis, there must be a rise above baseline levels of 10ppm of hydrogen in 60 minutes, or 20ppm of hydrogen in 90 minutes.

What is a high hydrogen SIBO reading? ›

Pimentel et al8 suggested that a rise in breath hydrogen 20 ppm above basal levels within 90 minutes after ingestion of lactulose should be considered as diagnostic of SIBO.

What is a negative SIBO test? ›

Negative for SIBO

If you test negative, it's possible that you have dysbiosis lower down in your large intestine, or a fungal overgrowth, which doesn't show up on SIBO breath tests.

Should I do a 2 hour or 3 hour SIBO test? ›

Clinicians have the option of a 2 or 3-hour SIBO assessment. The 3-hour SIBO profile provides insight into gas levels over a longer period of time, and is recommended for patients with slower gastrointestinal transit or constipation.

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