SIBO test: What should be considered


A translated guest post from our Dutch partner All Ways Healthy

Do you suspect you have SIBO - a bacterial overgrowth in the small intestine? Do you regularly suffer from SIBO symptoms such as bloating after eating, bloating, stomach pain or nausea? Then it might be advisable to do a SIBO breath test. This simple test will help you determine not only whether SIBO is present, but also what type it is. This is crucial for choosing the right treatment strategy. In this article you will learn more about how this test works and how to interpret the results. 

What is a SIBO breath test?

SIBO is a bacterial overgrowth in the small intestine. To detect this condition, a SIBO breath test can be performed. This test measures gas production through breath samples after drinking a sugar solution - lactulose or glucose - measured. These samples are taken every 20 minutes for up to 180 minutes. The samples are then sent to a laboratory for further analysis. Two types of gases are examined: hydrogen and methane gas. The results show which gases are produced, when they are produced and to what extent. This provides clues that may indicate SIBO. 

SIBO test with lactulose or glucose?

Two types of sugar solutions can be chosen for the SIBO breath test: with lactulose or with glucose. Of both will lactulose most commonly used by SIBO specialists. There are the following reasons for this: 


Glucose is more likely to miss distal SIBO (bacterial overgrowth in the last part of the small intestine) because it can be absorbed higher up in the digestive tract. 


lactulose cannot be absorbed into the intestinal system and is therefore able to measure bacterial overgrowth throughout the small intestine, even if the overgrowth is in the final part of the small intestine. 

lactulose has no effect on blood sugar levels and is therefore the better choice for diabetics. 


However, these reasons do not mean that the glucose test is completely worthless. In certain cases, a glucose test can even be used to provide an inconclusive result lactulose-Breathing tests to confirm. 



How to prepare for the SIBO test?

Ordering the SIBO test:

You can order a SIBO breath test here on the website. On the order page you can lactulose, glucose or a combination of both. For more information about the other tests, we recommend that you consult a therapist. 


Once you have the test in hand, you should go through the following steps to prepare properly: 


1 month before the test:

Wait at least 4 weeks before taking the test after:  

an antibiotic treatment,  a colonoscopy,  colonic lavage,  

or an X-ray examination with oral contrast medium. 


1 week before the test:

Stop taking:  

Prebiotics, probiotics and probiotic products (e.g. yogurt and fermented products)  

Antifungal drugs 

Plant-based antimicrobials 


24-48 hours before the test:

 Follow the preparatory diet starting 24 hours before the test - or 48 hours if constipation is present. The diet is explained in more detail in the accompanying instructions. 

Stop taking: 



Dietary supplements 


12 hours before the test:

 Fasting for 12 hours before the test, e.g. B. overnight. Do not eat or drink anything other than water before and during the test. If possible and only in consultation with your doctor, avoid non-essential medications. 


1 hour before and during the test: 

Brush your teeth with water only (no toothpaste).  

Do not smoke on the day of the test or during the test, including passive smoking. 

Get up at least an hour before the test and do not sleep during the test.  

No sporting activities before or during the test. 


Further details can be found in the instructions for use provided with the SIBO test. 




How is the SIBO test done?

When you are ready to take the SIBO test, you can remove the glass tubes from the packaging and prepare the sugar solution. It is important that you follow the instructions on the additional leaflet step by step.  


After a baseline measurement, drink the sugar solution and then take a new breath sample every 20 minutes. After 180 minutes the final sample will be taken and you are finished with the test. You can put the tubes back in the packaging for return shipping. After providing all the necessary information, you can send the package back to the laboratory for further analysis. 



Evaluation of SIBO test

Once the laboratory has completed the analysis, you will receive the result by email. The result is given in the form of a chart with associated data. You should pay attention to the following points: 


Was there an increase in hydrogen gas, methane gas, or a combination of both before 120 minutes (cut-off value for gas production in the small or large intestine)? 

Is this increase significant compared to the reference values? 

What is the shape of the curve: early or late increase? 


Statements about the situation can be made based on these points. It is advisable to do this together with someone specialized:n Doctor or Therapist: in to do so that a targeted treatment plan can be created. 


If you would like to learn for yourself how to interpret the result of a SIBO breath test and how to create a personal treatment plan based on this result, we recommend our GUT program All Ways Healthy niederland 


This online learning program is specifically designed to help you improve your intestinal symptoms independently.