The large intestine is packed with bacteria, whilst the small intestine typically contains very few bacteria. If the small intestine becomes overgrown with bacteria it can lead to malabsorption of key nutrients, causing symptoms such as nausea, vomiting, diarrohoea, bloating, fatigue, malabsorption of nutrients and weight loss. Small Intestinal Bacterial Overgrowth (SIBO) is also thought to be a possible factor in some cases of fibromyalgia and chronic fatigue syndrome.
What we test
SIBO Lactulose Breath Test
The lactulose test is used to measure oro-caecal transit time (OCTT) - this is the time interval between ingestion of lactulose and rise in breath hydrogen. Prolonged OCTT has been associated with SIBO.
Bacteria in the small intestine produce hydrogen and methane gas when exposed to lactulose. Hydrogen excretion is indicated by >20ppm sustained rise upon lactulose challenge.
Bacteria in the small intestine produce hydrogen and methane gas when exposed to lactulose. Methane excretion is indicated by >10ppm sustained rise upon lactulose challenge.
Normal OCTT (the time it takes for lactulose to pass through the gut) in healthy adults is approx 60-120min.
Fructose Malabsorption
Hydrogen/methane breath tests are highly specific and sensitive tools for the diagnosis of FODMAP malabsorption. They are considered first line interventions in the diagnostic workup of IBS symptoms and are recommended before dietary intervention. Breath tests avoid unnecessary food restrictions and adverse effects on gut microflora.
This represents the amount of hydrogen present in an exhaled breath a period of time after taking the fructose dose. Hydrogen is produced by microbial fermentation of carbohydrates in the gut.
Breath hydrogen is used for measurement of malabsorption where possible. If breath hydrogen production is low, further tests are conducted using equipment that also measures methane (CH4).
Test instructions
Your test kit and all instructions are posted directly to you, and there is no need to visit a collection centre.
Mail your sample back to the lab using the prepaid envelope and packaging.
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