Kresser Institute

Tools, Training & Community for Functional Health Professionals

SIBO

I’ve heard that PHGG is less well tolerated with methane-predominant SIBO and that it may be best with hydrogen-predominant SIBO. Have you observed this?

Dr. Amy Nett: I have not, actually. I’ve found that partially hydrolyzed guar gum is actually pretty well tolerated by...

I have a patient who I want to do the SIBO test, and she’s really afraid of lactulose because dairy exacerbates her Hashimoto’s skin rash. I want to assure her it’s OK, but I’m not sure if it is.

Dr. Amy Nett: Yeah, if a patient has a significant reaction to dairy that they think is due to the...

Regarding the SIBO breath testing, are there any special considerations for diabetic patients on oral medications or insulin concerning hyperglycemic or hypoglycemic reactions during the collection window? It would seem that 12 hours of fasting and then 100 grams of glucose followed by three hours of no other foods would be very likely to cause adverse reactions.

Dr. Amy Nett: That’s a great question. In this particular case, I generally use lactulose. I don’t use glucose a...

Does Genova’s SIBO test use glucose or lactulose?

Dr. Amy Nett: I believe you can order either glucose or lactulose from Genova. I think when patients self-order they...

I have a question regarding SIBO lactulose breath test interpretation. The test result has a classic double peak with hydrogen at 14 parts per million at 90 minutes, dips down, and then peaks again at 15 parts per million after 160 minutes. Does this suggest SIBO? I’m not sure if it needs to be over 20 parts per million.

Chris Kresser: Yeah, that wouldn’t be suggestive of SIBO. There has to be an increase of over 20 parts per...

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