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  4. 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.

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 million, according to the classic criteria, from the baseline value. We don’t know what the baseline value here is, but we can know just from what you’ve provided me with that it never increased by more than 20 parts per million because it never got above 20 parts per million. The more liberal, more recent criteria from Dr. Pimentel states that a value over 20 parts per million at any point in the test would be positive, so it’s not just the strict double-peak criteria, and even that wouldn’t be satisfied here. So I can’t say for sure without seeing this, but I can 99.9 percent say that this is not SIBO, at least according to hydrogen. I’m not sure if you got methane, but at least according to what you’ve said here, it doesn’t look like SIBO.

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