SIBO Testing: Things to Know and How to Prepare
SIBO testing is done in one of two ways:
Some basic info about the testing (using either method):
**For both methods of testing, please follow these preparation guidelines, beginning 2 weeks before your test:
HOW TO PREPARE FOR YOUR TEST:
**2 WEEKS BEFORE YOUR TEST (ie. NOW)
Finish taking any antibiotics or antifungal medications (oregano oil counts). Do not undergo colonoscopy or barium enemas during this time (regular home enemas like Fleet enemas are ok).
**7 DAYS BEFORE YOUR TEST (ie. NOW)
Unless otherwise directed by your provider, please avoid Proton Pump Inhibitors (PPIs). PPIs are “acid blocking” medications used for heartburn or allergies. Please notify me if you are taking these medications and forgot to tell me.
**4 DAYS BEFORE YOUR TEST (ie. NOW/SOON)
Avoid all laxatives including Vitamin C and Magnesium.
Avoid all probiotic supplements and fermented foods.
1-2 DAYS BEFORE YOUR TEST
You must refrain from all high fibre and lactose-containing foods. These foods can ferment in your gut, and can potentially cause false results. If you have constipation, please refrain from fibre and lactose-containing foods for the full two days.
The following list of food options are acceptable for the preparatory diet.
If you are unsure if something will a interfere the test, DO NOT CONSUME the product and/or consult with me.
12 HOURS BEFORE YOUR TEST
Begin fasting. Avoid all food, drinks (except water) and non-essential medication. You should also avoid laxative use from now until the test is complete.
THE DAY OF YOUR TEST
Wake up at least one hour prior to beginning collection. You may brush your teeth as normal. No smoking or vigorous exercise for at least one hour prior to collection.
- With a traditional SIBO breath test kit, or
- Using the Aire 2 through FoodMarble.
Some basic info about the testing (using either method):
- You must fast for 12 hours prior to the test. (Diabetic patients should consult with their provider prior to fasting to ensure this test is safe for them.)
- The test takes 3 hours to complete.
- Plan on doing the test on a morning that you can dedicate three hours to testing.
- Some patients may experience SIBO- related symptoms or exacerbation of their symptoms after drinking the test solution. These symptoms may last for up to 24 hours.
**For both methods of testing, please follow these preparation guidelines, beginning 2 weeks before your test:
HOW TO PREPARE FOR YOUR TEST:
**2 WEEKS BEFORE YOUR TEST (ie. NOW)
Finish taking any antibiotics or antifungal medications (oregano oil counts). Do not undergo colonoscopy or barium enemas during this time (regular home enemas like Fleet enemas are ok).
**7 DAYS BEFORE YOUR TEST (ie. NOW)
Unless otherwise directed by your provider, please avoid Proton Pump Inhibitors (PPIs). PPIs are “acid blocking” medications used for heartburn or allergies. Please notify me if you are taking these medications and forgot to tell me.
**4 DAYS BEFORE YOUR TEST (ie. NOW/SOON)
Avoid all laxatives including Vitamin C and Magnesium.
Avoid all probiotic supplements and fermented foods.
1-2 DAYS BEFORE YOUR TEST
You must refrain from all high fibre and lactose-containing foods. These foods can ferment in your gut, and can potentially cause false results. If you have constipation, please refrain from fibre and lactose-containing foods for the full two days.
The following list of food options are acceptable for the preparatory diet.
- Any baked or broiled meat or fish (raw fish is allowed too)
- White Bread
- Plain, steamed white rice (If you are on a grain free diet, please do not consume rice)
- Eggs
- Clear meat broth (no bouillon, bone/cartilage or vegetable broth)
- Fats/oils (e.g., coconut/olive/vegetable oil, butter, lard)
- Salt and pepper
- Weak black coffee/tea (plain, no sweeteners or cream)
If you are unsure if something will a interfere the test, DO NOT CONSUME the product and/or consult with me.
12 HOURS BEFORE YOUR TEST
Begin fasting. Avoid all food, drinks (except water) and non-essential medication. You should also avoid laxative use from now until the test is complete.
THE DAY OF YOUR TEST
Wake up at least one hour prior to beginning collection. You may brush your teeth as normal. No smoking or vigorous exercise for at least one hour prior to collection.
Method 1:
Testing with a traditional SIBO breath test kit
For this test, you'll need to have purchased a SIBO breath test kit from my office, or one may have been shipped directly to you. After you have followed the two week prep above, you're ready to test.
COLLECTION PROCEDURE - day of testing
Lay out your kit contents. You should have received: glass vials, labels, a packet of substrate, an “EasySampler” collection device, bubble-wrap sleeves, and a worksheet to record collection times. If you weigh less than 100 pounds, please roll down the blue collection bag to the correct weight and staple. Do not consume any solution yet. Wait until after you have collected the baseline #1 breath sample.
**Do not insert your finger into the tube sampler — there is a sharp needle.
**Note that steps 1-4 are performed during one single continuous breath for each tube collected. ***
1. Take a normal breath in, not a deep breath. (This is vital to ensure that your breath is not contaminated with room air!) Close your mouth around the mouthpiece and exhale normally.
2. Continue to blow into the mouthpiece to inflate the bag fully. (Note that there are two small holes in the blue collection bag. They are intentional. Please do not obstruct these holes.) Keep blowing.
3. While still continuing to exhale, completely insert the test tube into the needle-holder so that the rubber stopper is punctured. Keep blowing.
4. After 1-2 seconds, pull the tube out of the needle-holder and set it aside. Do not stop exhaling until after the tube is removed from the holder. Note, you will not see or hear your breath inside of the tube. The tubes have a vacuum that will suck in the exact amount needed for analysis in 1-2 seconds. Do not puncture the tube twice.
5. Immediately after collecting the baseline #1 breath sample, you need to consume the substrate solution for the test. Do not follow dosage instructions printed on the packet.
Instead, mix the entire packet of substrate with 8 ounces of water. You must mix the solution within 3-5 minutes. (If you weigh less than 50 pounds, please consult with laboratory personnel for proper dosage instructions.) After drinking the solution you may resume quiet activity, but do not eat, smoke, sleep or exercise vigorously for the duration of the test. Drinking water is allowed in moderation. After drinking solution, collect another breath sample every 20 minutes for the next three hours, using all ten tubes
provided. Please record the date and time each tube is collected on both the tube labels and the worksheet. You should also record any symptoms you experience during the test. When finished, put the tubes into the protective bubble wrap sleeve(s). Place the protected tubes, the EasySampler, and any paperwork into the box and seal with the prepaid sticker that was provided for shipping.
After the lab receives your kit, results will be sent directly to me within two weeks and I will notify you when they are in and ready to review.
COLLECTION PROCEDURE - day of testing
Lay out your kit contents. You should have received: glass vials, labels, a packet of substrate, an “EasySampler” collection device, bubble-wrap sleeves, and a worksheet to record collection times. If you weigh less than 100 pounds, please roll down the blue collection bag to the correct weight and staple. Do not consume any solution yet. Wait until after you have collected the baseline #1 breath sample.
**Do not insert your finger into the tube sampler — there is a sharp needle.
**Note that steps 1-4 are performed during one single continuous breath for each tube collected. ***
1. Take a normal breath in, not a deep breath. (This is vital to ensure that your breath is not contaminated with room air!) Close your mouth around the mouthpiece and exhale normally.
2. Continue to blow into the mouthpiece to inflate the bag fully. (Note that there are two small holes in the blue collection bag. They are intentional. Please do not obstruct these holes.) Keep blowing.
3. While still continuing to exhale, completely insert the test tube into the needle-holder so that the rubber stopper is punctured. Keep blowing.
4. After 1-2 seconds, pull the tube out of the needle-holder and set it aside. Do not stop exhaling until after the tube is removed from the holder. Note, you will not see or hear your breath inside of the tube. The tubes have a vacuum that will suck in the exact amount needed for analysis in 1-2 seconds. Do not puncture the tube twice.
5. Immediately after collecting the baseline #1 breath sample, you need to consume the substrate solution for the test. Do not follow dosage instructions printed on the packet.
Instead, mix the entire packet of substrate with 8 ounces of water. You must mix the solution within 3-5 minutes. (If you weigh less than 50 pounds, please consult with laboratory personnel for proper dosage instructions.) After drinking the solution you may resume quiet activity, but do not eat, smoke, sleep or exercise vigorously for the duration of the test. Drinking water is allowed in moderation. After drinking solution, collect another breath sample every 20 minutes for the next three hours, using all ten tubes
provided. Please record the date and time each tube is collected on both the tube labels and the worksheet. You should also record any symptoms you experience during the test. When finished, put the tubes into the protective bubble wrap sleeve(s). Place the protected tubes, the EasySampler, and any paperwork into the box and seal with the prepaid sticker that was provided for shipping.
After the lab receives your kit, results will be sent directly to me within two weeks and I will notify you when they are in and ready to review.
Method 2:
Testing using an Aire 2 from FoodMarble
For this test, you'll need to have purchased an Aire 2 breath test device from FoodMarble. If you are hoping to do SIBO testing with it, you'll need to use the link in the invitation email from my office in order to access SIBO testing, and in order for me to order SIBO tests and view your results. If you'd like to order a FoodMarble device for the purpose of SIBO testing, please contact the office.
Once you have ordered your device, you will need to download the green FoodMarble Healthcare App. (Do not download the blue app). You'll also need to purchase lactulose solution from any pharmacy over the counter - you can ask the pharmacist for it. Cost should be about $20 for 500 mL.
3-5 days before testing:
Contact our office by sending an email to [email protected] and let us know you are getting ready to do the SIBO test. On our end, we will "prompt" the app to tell you it's time to do a SIBO test. You will then not be able to use the app again to log data until you have completed the SIBO test.
COLLECTION PROCEDURE - day of testing
Lay out your supplies including your phone/app, Aire 2 device, and lactulose solution. Do not consume any solution yet. Wait until after you have collected the baseline #1 breath sample.
Follow the directions on the app and breathe into the device as prompted to provide your baseline breath sample.
Then, mix 20 mL of lactulose with 8 ounces of water. You must mix the solution within 3-5 minutes. (If you weigh less than 50 pounds, please consult with laboratory personnel for proper dosage instructions.) After drinking the solution you may resume quiet activity, but do not eat, smoke, sleep or exercise vigorously for the duration of the test. Drinking water is allowed in moderation. After drinking the lactulose solution, collect another breath sample every 20 minutes for the next three hours, as directed by the app. Following your test, you results are sent to our office.
I will notify you when the results are in and ready to review.
Once you have ordered your device, you will need to download the green FoodMarble Healthcare App. (Do not download the blue app). You'll also need to purchase lactulose solution from any pharmacy over the counter - you can ask the pharmacist for it. Cost should be about $20 for 500 mL.
3-5 days before testing:
Contact our office by sending an email to [email protected] and let us know you are getting ready to do the SIBO test. On our end, we will "prompt" the app to tell you it's time to do a SIBO test. You will then not be able to use the app again to log data until you have completed the SIBO test.
COLLECTION PROCEDURE - day of testing
Lay out your supplies including your phone/app, Aire 2 device, and lactulose solution. Do not consume any solution yet. Wait until after you have collected the baseline #1 breath sample.
Follow the directions on the app and breathe into the device as prompted to provide your baseline breath sample.
Then, mix 20 mL of lactulose with 8 ounces of water. You must mix the solution within 3-5 minutes. (If you weigh less than 50 pounds, please consult with laboratory personnel for proper dosage instructions.) After drinking the solution you may resume quiet activity, but do not eat, smoke, sleep or exercise vigorously for the duration of the test. Drinking water is allowed in moderation. After drinking the lactulose solution, collect another breath sample every 20 minutes for the next three hours, as directed by the app. Following your test, you results are sent to our office.
I will notify you when the results are in and ready to review.