I’ve gone through the SIBO test. I’m absolutely sure I could not do this with my son. Both the preparation and not eating for so long in the morning. I really want to treat his gut because he has neurologic issues and was born with them from the get-go. I could get him to do stool testing, but I think he would be insufferable, crying, to not be able to eat for so long in the morning. It’s difficult to do testing on him, in general, because of his issues. Catching stool, urine, and saliva has worked, but blood is not easy. Do you think I can do the organic acids test and the stool test and go from there without SIBO?

Dr. Amy Nett: Absolutely! Similar to the skin rash, we don’t want to torture people with testing. We don’t want to torture you or your son. And it’s entirely possible that you might find things on the organic acids test and the stool testing that give you a reason to treat, so if you find dysbiosis or yeast overgrowth on either of those tests, I don’t even know that a SIBO breath test would necessarily change the treatment recommendations because you could still use the herbal antimicrobial protocol. For an 11-year-old, for the organic acids test, I might use the Great Plains test. For urine organic acids testing, remember you can do either the Great Plains or the Genova, and for children, we generally use the Great Plains test because they have a few more markers for yeast overgrowth which can be helpful, and then they also have more markers for Clostridia species. So think about doing the Great Plains one. Then stool testing—of course, if you can do both Doctor’s Data and BioHealth, great, because again, you can use the same stool. Even though I think BioHealth is four days and Doctor’s Data is three days, you can use the same stool samples to potentially overlap the collection, and so it might be a more thorough evaluation with only one additional day of stool collection. If you come up completely empty handed from that and you suspect SIBO clinically, then the consideration is, is it worth doing a therapeutic trial of rifaximin? You’ve heard us say how many times why guess when you can test, but this is one of the cases. We don’t want to torture you and your son, but if you were to have a concern that SIBO was a real issue for him, rifaximin might be safe enough that you could do something like a 10-day trial, and if you start noticing improvements, then that might be therapeutic and diagnostic.

Again, it’s so nice to be able to do a SIBO breath test, two stool tests, and urine organic acid testing to understand what’s going on in the gut, but it’s definitely not necessary. I think you’ll get plenty of information even without the SIBO breath test.