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Small Intestinal Bacterial Overgrowth (SIBO) Breath Test

What Is A SIBO Breath Test?

Small Intestinal Bacterial Overgrowth (SIBO) is defined as an excess of bacteria in the small intestine.  Once present, it has been suggested that this imbalance of bacteria may induce an inflammatory response in the small intestinal mucosa which produces many of the symptoms associated with this condition.  Treatment of SIBO is aimed at reducing the bacterial overload, correcting the underlying cause, and providing nutritional support including supplementation of any vitamin or mineral deficiencies that may be necessary. Antibiotics remain the mainstay of therapy and have been demonstrated to be effective in restoring normal bacterial balance, reducing mucosal inflammation and eliminating associated symptoms.


How Do You Prepare For A SIBO Breath Test?

General Considerations

  • Wait at least 4 weeks after a colonoscopy or barium enema before beginning the test.
  • If you are using antibiotics, antifungals or Pepto-Bismol, wait at least 2 weeks from your last dose before beginning this test.
  • It is not recommended to perform this exam during an acute infectious illness.

Medications and Diet Instructions:

One Week Prior:

  • Avoid the use of laxatives, stool softeners and/ or stool bulking agents (Ex-Lax, Colace, Metamucil, Miralax).
  • Avoid the use of antacids containing aluminum or magnesium hydroxide (Maalox, Milk of Magnesia, Mylanta, Rolaids).
  • Hold Proton Pump Inhibitors (PPIs) (Omeprazole, Lansoprazole, Dexlansoprazole, Esomeprazole, Pantoprazole, Rabeprazole)
  • Hold motility agents such as Loperamide (Imodium) or Metoclopramide (Reglan) for 2 days prior to testing

Day Before The Procedure:

  • Follow a low-residue diet that minimizes non absorbable carbohydrates (starches and sugars)
  • Avoid fruits (including fruit juices) and vegetables, sugar, fiber or bran cereals, high fiber foods/ whole grains, nuts, seeds, beans, milk, ice cream, yogurt, butter and alcoholic beverages.
  • A typical prep diet is limited to steamed white rice, white bread, baked or broiled fish/ poultry/ meat with salt and pepper only, eggs, hard cheeses, clear beef or chicken broth (not bone broth or bouillon). Drink water, non-flavored black coffee or tea.

Day Of The Procedure:

  • No food or drink other than water for 12 hours prior to your breath test.
  • You may take your prescription medications with a sip of water on the morning of the test.
  • You may brush your teeth on the morning of the test.
  • No smoking, including second-hand smoke, for at least 1 hour before or at any time during the breath test.
  • No sleeping or vigorous exercise for at least 1 hour before or at any time during the breath test.


What Can You Expect During A SIBO Breath Test?

You will start by gently blowing into a bag to get an initial breath sample.  You will then drink a solution containing different types of sugar. You’ll then breath into a bag every 15 to 20 minutes as your body digests the solution. After each breath, your doctor will use a syringe to empty the bag.  The test could last between 90 and 120 minutes so come prepared.


What Is The Follow Up For A SIBO Breath Test?

If the amount of hydrogen in your breath changes after you drink the sugar solution, if it increases by more than 20 ppm after drinking the solution, you may have a sugar intolerance or SIBO.


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Meet Jennifer Bonheur, MD

Dr. Jennifer Bonheur is a board-certified gastroenterologist who loves her work and values her relationships with her patients. As a female gastroenterologist, she strives to connect and treat the patient and not simply the illness. Dr. Bonheur offers specialized care in gastroenterology and therapeutic endoscopy. Together with her staff, she is committed to providing the highest quality medical care in a comfortable, professional and personalized environment. Learn More »