Kresser Institute

Tools, Training & Community for Functional Health Professionals

SIBO

Is there any contraindication to a person with SIBO or pathogenic bacteria or yeast overgrowth taking prebiotics other than PHGG? I’m confused because in the past you mentioned that a person with SIBO should be cautious at this time. Should it just be used in the rebuild phase?

Chris Kresser: The addition of PHGG is only for people who have SIBO and are doing a concurrent antimicrobial protocol....

I’m under the impression that SIBO can cause bad breath as far as a gut infection, but can a parasite such as Blastocystis cause halitosis?

Chris Kresser: Yes. Anything that disrupts the gut microbiome can cause halitosis because you’re getting production of certain gases, which...

A 28-year-old female, long-term severe bloating after eating but no pain or other digestive symptoms. Has tried many approaches for her symptoms, including low FODMAP, removing problem foods from IgG panel, probiotics, removing gluten and dairy, osteopathy. There is more, but the point is she has tried a lot, and none of it has made a difference. I suggested a SIBO breath test and posted the results in the Facebook group recently. Small early rise in hydrogen but below 20 parts per million. In this situation, would you suggest a one-month therapeutic trial of the SIBO protocol, or would money be better spent on a stool test? Funds are tight, so I’m hoping to offer the most cost-effective option.

Chris Kresser: Yes, I mean, this is a great clinical question here. So, if you think it through, if there...

I’m still really confused about why lactulose is preferred over glucose for SIBO testing. It seems like glucose would give more accurate results. Some literature claims glucose is better and more accurate. I’m also unclear why Genova is so unpreferred with you and Amy. Is it only the two-hour test that you disapprove of or is it the lab? I know they are possibly willing to bring back the three-hour lactulose test, but it seems like you don’t approve of the lab. Is that correct? Since this testing is so murky and controversial, it would be good to get it right, of course.

Chris Kresser: Lactulose, I don’t know that you could say it is preferred. I think a lot of clinicians prefer...

Maybe I’m jumping ahead of myself here, as this will probably be covered in more detail in the blood chemistry portion, but how do you determine who’s a hyper-responder—familial hypercholesterolemia or ApoE4 genotype—to dietary cholesterol and saturated fat?

Chris Kresser: Basically, as I said earlier, if you address all of the other underlying issues and the patient still...

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