Our specialists regularly review advancements in health and wellness, ensuring our articles are updated with the newest information as it becomes accessible.
Recent Updates
June 12, 2024
Our specialists regularly review advancements in health and wellness, ensuring our articles are updated with the newest information as it becomes accessible.
Small intestinal bacterial overgrowth (SIBO) is a common digestive disorder often mistaken for irritable bowel syndrome. Because SIBO often causes food intolerances and digestive symptoms related to meal times, knowing what and how to eat can be difficult for patients. Successful treatment of SIBO requires a multifaceted approach that includes antimicrobial therapy and dietary modifications, among other interventions, to eradicate bacterial overgrowth, palliate disruptive digestive symptoms, and prevent SIBO recurrence. This article will discuss five therapeutic diets that can be included in a SIBO protocol.
[signup]
What is Small Intestinal Bacterial Overgrowth (SIBO)?
According to the American College of Gastroenterology, SIBO is the presence of excessive numbers of bacteria in the small intestine, causing gastrointestinal (GI) symptoms (1). In a healthy digestive tract, the small intestine should have little bacterial growth compared to the large intestine. Various factors that prevent bacterial translocation through the small intestine into the large intestine or allow for the migration of bacteria from the colon into the small intestine can contribute to SIBO.
Advances in research have allowed the SIBO diagnosis to become more nuanced, and three distinct SIBO subtypes have been identified. Hydrogen (H2) SIBO is the overgrowth of H2-producing bacteria within the small intestine. Intestinal methanogen overgrowth (IMO), previously called methane (CH4) SIBO, is the overgrowth of methanogens in the small or large intestines. Hydrogen sulfide (H2S) SIBO is the overgrowth of H2S-producing organisms in the small intestine. (2)
Additionally, SIBO research has led to increased knowledge of SIBO's role in the development and progression of other diseases, including irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), systemic sclerosis, intestinal motility disorders, and cirrhosis. (1)
SIBO Symptoms
The signs and symptoms of SIBO arise from bacterial fermentation within the small intestine and pathologic changes to intestinal permeability and immune function caused by the excess numbers of microorganisms within the small intestine. The most common SIBO symptoms, present in more than two-thirds of SIBO patients, include abdominal pain, bloating, gas, abdominal distension, flatulence, and diarrhea. Other common SIBO symptoms include heartburn, reflux, nausea, and constipation. (1)
In more severe cases of SIBO, maldigestion and malabsorption can occur, leading to weight loss, fatty stools (steatorrhea), and evidence of nutrient deficiencies and anemias on lab results. (1, 2)
Increased intestinal permeability and low-grade inflammation can translate to symptoms outside the GI tract. Fatigue, brain fog, skin rashes, changes in mood, headaches, and joint pain can present secondary to SIBO-induced leaky gut. (2)
Certain symptom patterns are indicative of, but not diagnostic for, SIBO. These include:
Bloating progressively worsens after meals and throughout the day
Digestive symptoms are worse after eating high-fiber foods (e.g., whole grains, bran, beans, raw vegetables), onions, garlic, and apples
White bread and rice are better tolerated than whole wheat bread and brown rice
GI symptoms begin and persist after a bout of food poisoning, taking a proton pump inhibitor or opiate narcotics, or abdominal surgery
Taking antibiotics provides temporary relief and improvement in GI symptoms
Probiotics, especially those that contain prebiotics (e.g., FOS, GOS, inulin), worsen digestive symptoms
Who Could Benefit From a SIBO Diet?
While dietary modification is often used in clinical practice for patients with SIBO, research has yet to definitively determine its role in treatment. Dietary strategies predominantly emphasize the reduction of fermentable carbohydrates from the diet; it is unclear if the resulting clinical improvements are due to a reduction of intestinal bacterial concentrations or simply a reduction in fermentation and gas production. Regardless, dietary therapy, even without concurrent antimicrobial treatment, can be enough to provide symptom relief to patients. (3)
Given that SIBO diets can relieve SIBO symptoms, people with confirmed SIBO cases can consider initiating a SIBO diet before or during antibiotic or herbal eradication therapy. Dietary modifications may also be recommended for patients unable to perform diagnostic SIBO testing; improvement in digestive symptoms with the removal of fermentable carbohydrates is indicative and supports clinical suspicion of SIBO.
Functional Medicine Labs to Test That Can Help Support Individualized Dietary Modifications for SIBO Treatment
Functional medicine labs help practitioners personalize treatment options for their patients. Below are some of the most common labs ordered for patients suffering from SIBO.
SIBO Breath Test
The SIBO breath test is a noninvasive testing alternative to small intestinal culture, most commonly used in the clinical setting to diagnose SIBO and IMO. The SIBO breath test helps determine the subtype of SIBO and monitor SIBO treatment progress. Different SIBO breath tests are available, differentiated by their test substrate and duration. Currently, there is no universal standard for SIBO breath testing; the type of test ordered largely depends on the preference of the ordering provider.
The patient can perform the test in the comfort of their home after following a one-day preparatory diet. After the patient collects a baseline breath sample, they drink a solution that contains either glucose or lactulose. The patient continues to collect breath samples at timed intervals for the test duration (two or three hours). While most tests can only measure H2 and CH4 gas levels, the newest test on the market, trio-smart, can measure all three fermented gases associated with SIBO.
Comprehensive Stool Test
A comprehensive stool test cannot diagnose SIBO, but it can provide additional information regarding the health and function of the digestive tract that can guide dietary and other treatment recommendations. Biomarkers included on a comprehensive stool test to pay special attention to regarding SIBO include fecal markers of digestion and absorption, intestinal immunology and inflammation, and dysbiotic patterns.
The information provided on a comprehensive stool test supports a more holistic approach to digestive health and treating SIBO. By identifying the consequences of SIBO, such as maldigestion or leaky gut, therapeutic strategies can be implemented to palliate symptoms and correct imbalances. Additionally, stool results can reveal underlying root causes of SIBO development, like immune dysregulation or digestive enzyme deficiency, so they can be corrected to prevent future SIBO recurrence.
[signup]
Functional Medicine and Functional Nutrition Treatment Plan For SIBO Patients
Dietary modifications in the setting of SIBO treatment aim to reduce food sources for bacteria while nourishing the patient. Bacteria primarily ferment ("eat") carbohydrates, so you'll note that all diets discussed in this article are similar variations in dietary restrictions of fermentable carbohydrates, including starches, resistant starches, soluble fibers, sugar, and prebiotics.
SIBO Diets for a Successful SIBO Treatment Plan
Many diets can benefit patients with SIBO. The decision on which is used should be based on the patient's health history, lifestyle, preferences, and ability to follow the dietary plan consistently.
Low FODMAP
The low FODMAP diet is the most notorious and best-studied therapeutic elimination diet for SIBO and IBS. The low FODMAP diet improves digestive symptoms in up to 86% of patients with IBS. The high prevalence of SIBO in IBS patients rationalizes using this diet for SIBO management.
This diet eliminates four troublesome fermentable carbohydrate groups: oligosaccharides, disaccharides, monosaccharides, and polyols. A FODMAP elimination diet is a three-step dietary plan:
Step 1: Low FODMAP Diet
Swap high FODMAP foods for low FODMAP alternatives for 2-6 weeks. MONASH University is a great resource that uses a traffic light system to grade foods from all food groups as high, moderate, or low FODMAP. The elimination diet targets foods high in fructose, lactose, fructans, galactans, and polyols. It allows the consumption of grains, fiber, sugar, and other fermentable carbohydrates, which may trigger patients with SIBO even in low amounts. Because of this, the diet may need to be slightly adapted for those with SIBO.
Step 2: FODMAP Reintroduction
The patient should be advised to reintroduce moderate-to-high FODMAP foods back into the diet. One food should be rechallenged into the diet one at a time over three days to observe for GI/SIBO symptoms and test food tolerance. Reintroductions can be done at the patient's own rate, typically occurring over 8-12 weeks. FODMAP reintroductions allow patients to experiment with how much of a particular food is tolerated to individualize their diet to manage SIBO and digestive symptoms.
Step 3: FODMAP Personalization
Long-term dietary customization is determined through the patient's reintroduction challenges. Understanding tolerance of FODMAP foods helps to add and maintain variety in the diet by incorporating tolerated amounts of some high-FODMAP foods and avoiding others.
Specific Carbohydrate Diet (SCD)
Dr. Sidney Haas developed the SCD to treat celiac disease in the pediatric population, as explained in his book published in 1951, The Management of Celiac Disease. The SCD eliminates select carbohydrates (disaccharides and polysaccharides) that are more difficult for the digestive tract to break down, contributing to intestinal inflammation, dysbiosis, and digestive symptoms. For patients with SIBO, eliminating these carbohydrates reduces bacterial fermentation contributing to SIBO symptoms. (4)
Food products that contain fructooligosaccharides (FOS)
SIBO Bi-Phasic Diet (SIBO B-PD)
Developed by Dr. Nirala Jacobi, the SIBO B-PD combines principles of the low FODMAP and SCD diets to implement a phased dietary approach to treating SIBO that is timed in conjunction with antimicrobial therapy.
Phase 1: Reduce and Repair
The first phase of the B-PD is performed before antimicrobial therapy. This more restrictive phase focuses on eliminating all fermentable starches (grains, legumes, dairy, sugar, and certain fruits and vegetables) for 4-6 weeks or until digestive symptoms improve. Examples of approved Phase 1 foods include:
Unlimited vegetables: alfalfa sprouts, bamboo shoots, Bok choy, bell pepper, carrot, cucumber, eggplant, kale, lettuce, radicchio, radish, arugula, tomatoes
The second phase of the B-PD is followed for 4-6 weeks during prescription or herbal antibiotic SIBO therapy. Phase 2, while still a low-fiber diet, allows the reintroduction of dairy, legumes, and grains per patient tolerance to nourish the microbiome and augment antimicrobial SIBO treatment.
Gut and Psychology Syndrome Diet (GAPS)
The GAPS diet was adapted from the SCD by Dr. Natasha Campbell-McBride. The diet's premise is that numerous neurologic and mental health disorders are caused by leaky gut. The GAPS diet is an elimination diet aimed to decrease intestinal permeability and heal the gut; because it significantly reduces total carbohydrate intake, patients with SIBO often will see improvements in digestive symptoms.
The GAPS diet is the SCD with a few modifications. The GAPS diet emphasizes more fat, broth, juicing, and cultured vegetables than the SCD. It also highlights incorporating some highly fermentable foods, like avocado and onion, so it may need to be modified for patients with SIBO. Because it emphasizes more home cooking, the GAPS diet may be more challenging to follow than the SCD.
The GAPS diet calls for a structured six-stage introduction diet. The patient progresses through each stage as they can tolerate newly introduced foods into the diet. After completing all six stages, the patient can continue to the full GAPS diet. The phases of the GAPS diet are summarized below.
Introduction Diet
Stage 1: homemade meat or fish stock; homemade soups with meat or fish stock; dairy- or vegetable-based probiotic foods; ginger tea
Stage 2: Addition of raw organic egg yolks; stews and casseroles with meats and vegetables; homemade yogurt or kefir; juice from sauerkraut or vegetables; fermented fish; homemade ghee
Stage 3: Addition of avocado, scrambled eggs, sauerkraut, and other fermented vegetables
Stage 4: Addition of roasted and grilled meats; cold-pressed olive oil; freshly pressed juices; baked bread with ground nuts or seeds
Stage 5: Addition of cooked apple puree and raw vegetables
Stage 6: Addition of peeled raw apple, other fruits, and honey
Full GAPS Diet
The full GAPS diet introduces more foods into the diet that are intended to heal the gut. The diet guidelines recommend that 85% of consumed foods come from meat, fish, broth, eggs, fermented foods, and vegetables.
Elemental Diet
The elemental diet (ED) is the only diet at this time that has data to support its ability to treat SIBO, not just improve symptoms. The ED is a liquid, hypoallergenic formula of predigested nutrients mixed with water. It fulfills all human caloric and nutritional needs while being devoid of all nutrients needed to sustain bacterial life. As such, a 14-day course of ED is 80% effective in treating SIBO, and up to 85% effective when extended to 21 days (5).
[signup]
Summary
Many different diets can be used for SIBO management. Dietary modifications can be an integral aspect of a SIBO treatment plan for short- and long-term management of symptoms. Restrictive elimination diets are not intended to be followed forever; the goal instead should be to implement therapeutic dietary modifications for as little time as possible while SIBO is being eradicated and the underlying causes are being corrected to prevent SIBO relapse. Working with a functional nutritionist can help patients navigate the many SIBO therapeutic diets and implement challenging dietary modifications.
Small intestinal bacterial overgrowth (SIBO) is a common digestive concern often mistaken for irritable bowel syndrome. Because SIBO may lead to food intolerances and digestive symptoms related to meal times, knowing what and how to eat can be challenging for individuals. Addressing SIBO often requires a multifaceted approach that may include antimicrobial therapy and dietary modifications, among other interventions, to help manage bacterial overgrowth, alleviate disruptive digestive symptoms, and support digestive health. This article will discuss five dietary approaches that can be considered in a SIBO management plan.
[signup]
What is Small Intestinal Bacterial Overgrowth (SIBO)?
According to the American College of Gastroenterology, SIBO is characterized by the presence of excessive numbers of bacteria in the small intestine, which may contribute to gastrointestinal (GI) symptoms (1). In a healthy digestive tract, the small intestine typically has less bacterial growth compared to the large intestine. Various factors that affect bacterial movement through the small intestine into the large intestine or allow for the migration of bacteria from the colon into the small intestine can contribute to SIBO.
Advances in research have allowed the SIBO diagnosis to become more nuanced, and three distinct SIBO subtypes have been identified. Hydrogen (H2) SIBO is associated with the overgrowth of H2-producing bacteria within the small intestine. Intestinal methanogen overgrowth (IMO), previously called methane (CH4) SIBO, involves the overgrowth of methanogens in the small or large intestines. Hydrogen sulfide (H2S) SIBO is linked to the overgrowth of H2S-producing organisms in the small intestine. (2)
Additionally, SIBO research has led to increased knowledge of SIBO's potential role in the development and progression of other health conditions, including irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), systemic sclerosis, intestinal motility disorders, and cirrhosis. (1)
SIBO Symptoms
The signs and symptoms of SIBO may arise from bacterial fermentation within the small intestine and changes to intestinal permeability and immune function caused by the excess numbers of microorganisms within the small intestine. The most common SIBO symptoms, present in more than two-thirds of individuals with SIBO, include abdominal pain, bloating, gas, abdominal distension, flatulence, and diarrhea. Other common SIBO symptoms include heartburn, reflux, nausea, and constipation. (1)
In more severe cases of SIBO, issues with digestion and absorption can occur, potentially leading to weight loss, fatty stools (steatorrhea), and evidence of nutrient imbalances and anemias on lab results. (1, 2)
Increased intestinal permeability and low-grade inflammation can translate to symptoms outside the GI tract. Fatigue, brain fog, skin rashes, changes in mood, headaches, and joint pain can present secondary to SIBO-associated intestinal permeability. (2)
Certain symptom patterns may suggest, but are not diagnostic for, SIBO. These include:
Bloating progressively worsens after meals and throughout the day
Digestive symptoms are worse after eating high-fiber foods (e.g., whole grains, bran, beans, raw vegetables), onions, garlic, and apples
White bread and rice are better tolerated than whole wheat bread and brown rice
GI symptoms begin and persist after a bout of food poisoning, taking a proton pump inhibitor or opiate narcotics, or abdominal surgery
Taking antibiotics provides temporary relief and improvement in GI symptoms
Probiotics, especially those that contain prebiotics (e.g., FOS, GOS, inulin), worsen digestive symptoms
Who Could Benefit From a SIBO Diet?
While dietary modification is often used in clinical practice for individuals with SIBO, research has yet to definitively determine its role in management. Dietary strategies predominantly emphasize the reduction of fermentable carbohydrates from the diet; it is unclear if the resulting clinical improvements are due to a reduction of intestinal bacterial concentrations or simply a reduction in fermentation and gas production. Regardless, dietary therapy, even without concurrent antimicrobial treatment, may be enough to provide symptom relief to individuals. (3)
Given that SIBO diets can help relieve SIBO symptoms, people with confirmed SIBO cases can consider initiating a SIBO diet before or during antibiotic or herbal management therapy. Dietary modifications may also be recommended for individuals unable to perform diagnostic SIBO testing; improvement in digestive symptoms with the removal of fermentable carbohydrates may support clinical suspicion of SIBO.
Functional Medicine Labs to Test That Can Help Support Individualized Dietary Modifications for SIBO Management
Functional medicine labs can help practitioners personalize management options for their patients. Below are some of the most common labs ordered for individuals experiencing SIBO.
SIBO Breath Test
The SIBO breath test is a noninvasive testing alternative to small intestinal culture, most commonly used in the clinical setting to assess SIBO and IMO. The SIBO breath test helps determine the subtype of SIBO and monitor SIBO management progress. Different SIBO breath tests are available, differentiated by their test substrate and duration. Currently, there is no universal standard for SIBO breath testing; the type of test ordered largely depends on the preference of the ordering provider.
The patient can perform the test in the comfort of their home after following a one-day preparatory diet. After the patient collects a baseline breath sample, they drink a solution that contains either glucose or lactulose. The patient continues to collect breath samples at timed intervals for the test duration (two or three hours). While most tests can only measure H2 and CH4 gas levels, the newest test on the market, trio-smart, can measure all three fermented gases associated with SIBO.
Comprehensive Stool Test
A comprehensive stool test cannot diagnose SIBO, but it can provide additional information regarding the health and function of the digestive tract that can guide dietary and other management recommendations. Biomarkers included on a comprehensive stool test to pay special attention to regarding SIBO include fecal markers of digestion and absorption, intestinal immunology and inflammation, and dysbiotic patterns.
The information provided on a comprehensive stool test supports a more holistic approach to digestive health and addressing SIBO. By identifying the consequences of SIBO, such as issues with digestion or intestinal permeability, strategies can be implemented to alleviate symptoms and support balance. Additionally, stool results can reveal underlying factors contributing to SIBO development, like immune dysregulation or digestive enzyme deficiency, so they can be addressed to support future digestive health.
[signup]
Functional Medicine and Functional Nutrition Management Plan For SIBO Patients
Dietary modifications in the setting of SIBO management aim to reduce food sources for bacteria while nourishing the individual. Bacteria primarily ferment ("eat") carbohydrates, so you'll note that all diets discussed in this article are similar variations in dietary restrictions of fermentable carbohydrates, including starches, resistant starches, soluble fibers, sugar, and prebiotics.
SIBO Diets for a Successful SIBO Management Plan
Many diets can benefit individuals with SIBO. The decision on which is used should be based on the individual's health history, lifestyle, preferences, and ability to follow the dietary plan consistently.
Low FODMAP
The low FODMAP diet is the most well-known and best-studied therapeutic elimination diet for SIBO and IBS. The low FODMAP diet may improve digestive symptoms in individuals with IBS. The high prevalence of SIBO in IBS patients supports using this diet for SIBO management.
This diet eliminates four troublesome fermentable carbohydrate groups: oligosaccharides, disaccharides, monosaccharides, and polyols. A FODMAP elimination diet is a three-step dietary plan:
Step 1: Low FODMAP Diet
Swap high FODMAP foods for low FODMAP alternatives for 2-6 weeks. MONASH University is a great resource that uses a traffic light system to grade foods from all food groups as high, moderate, or low FODMAP. The elimination diet targets foods high in fructose, lactose, fructans, galactans, and polyols. It allows the consumption of grains, fiber, sugar, and other fermentable carbohydrates, which may trigger individuals with SIBO even in low amounts. Because of this, the diet may need to be slightly adapted for those with SIBO.
Step 2: FODMAP Reintroduction
The individual should be advised to reintroduce moderate-to-high FODMAP foods back into the diet. One food should be rechallenged into the diet one at a time over three days to observe for GI/SIBO symptoms and test food tolerance. Reintroductions can be done at the individual's own rate, typically occurring over 8-12 weeks. FODMAP reintroductions allow individuals to experiment with how much of a particular food is tolerated to individualize their diet to manage SIBO and digestive symptoms.
Step 3: FODMAP Personalization
Long-term dietary customization is determined through the individual's reintroduction challenges. Understanding tolerance of FODMAP foods helps to add and maintain variety in the diet by incorporating tolerated amounts of some high-FODMAP foods and avoiding others.
Specific Carbohydrate Diet (SCD)
Dr. Sidney Haas developed the SCD to support individuals with celiac disease in the pediatric population, as explained in his book published in 1951, The Management of Celiac Disease. The SCD eliminates select carbohydrates (disaccharides and polysaccharides) that are more difficult for the digestive tract to break down, which may contribute to intestinal inflammation, dysbiosis, and digestive symptoms. For individuals with SIBO, eliminating these carbohydrates may reduce bacterial fermentation contributing to SIBO symptoms. (4)
Food products that contain fructooligosaccharides (FOS)
SIBO Bi-Phasic Diet (SIBO B-PD)
Developed by Dr. Nirala Jacobi, the SIBO B-PD combines principles of the low FODMAP and SCD diets to implement a phased dietary approach to managing SIBO that is timed in conjunction with antimicrobial therapy.
Phase 1: Reduce and Repair
The first phase of the B-PD is performed before antimicrobial therapy. This more restrictive phase focuses on eliminating all fermentable starches (grains, legumes, dairy, sugar, and certain fruits and vegetables) for 4-6 weeks or until digestive symptoms improve. Examples of approved Phase 1 foods include:
Unlimited vegetables: alfalfa sprouts, bamboo shoots, Bok choy, bell pepper, carrot, cucumber, eggplant, kale, lettuce, radicchio, radish, arugula, tomatoes
The second phase of the B-PD is followed for 4-6 weeks during prescription or herbal antibiotic SIBO therapy. Phase 2, while still a low-fiber diet, allows the reintroduction of dairy, legumes, and grains per individual tolerance to nourish the microbiome and support antimicrobial SIBO management.
Gut and Psychology Syndrome Diet (GAPS)
The GAPS diet was adapted from the SCD by Dr. Natasha Campbell-McBride. The diet's premise is that numerous neurologic and mental health concerns are associated with intestinal permeability. The GAPS diet is an elimination diet aimed to decrease intestinal permeability and support gut health; because it significantly reduces total carbohydrate intake, individuals with SIBO often may see improvements in digestive symptoms.
The GAPS diet is the SCD with a few modifications. The GAPS diet emphasizes more fat, broth, juicing, and cultured vegetables than the SCD. It also highlights incorporating some highly fermentable foods, like avocado and onion, so it may need to be modified for individuals with SIBO. Because it emphasizes more home cooking, the GAPS diet may be more challenging to follow than the SCD.
The GAPS diet calls for a structured six-stage introduction diet. The individual progresses through each stage as they can tolerate newly introduced foods into the diet. After completing all six stages, the individual can continue to the full GAPS diet. The phases of the GAPS diet are summarized below.
Introduction Diet
Stage 1: homemade meat or fish stock; homemade soups with meat or fish stock; dairy- or vegetable-based probiotic foods; ginger tea
Stage 2: Addition of raw organic egg yolks; stews and casseroles with meats and vegetables; homemade yogurt or kefir; juice from sauerkraut or vegetables; fermented fish; homemade ghee
Stage 3: Addition of avocado, scrambled eggs, sauerkraut, and other fermented vegetables
Stage 4: Addition of roasted and grilled meats; cold-pressed olive oil; freshly pressed juices; baked bread with ground nuts or seeds
Stage 5: Addition of cooked apple puree and raw vegetables
Stage 6: Addition of peeled raw apple, other fruits, and honey
Full GAPS Diet
The full GAPS diet introduces more foods into the diet that are intended to support gut health. The diet guidelines recommend that 85% of consumed foods come from meat, fish, broth, eggs, fermented foods, and vegetables.
Elemental Diet
The elemental diet (ED) is the only diet at this time that has data to support its potential to help manage SIBO, not just improve symptoms. The ED is a liquid, hypoallergenic formula of predigested nutrients mixed with water. It fulfills all human caloric and nutritional needs while being devoid of all nutrients needed to sustain bacterial life. As such, a 14-day course of ED may be effective in managing SIBO, and extending it to 21 days may increase its effectiveness (5).
[signup]
Summary
Many different diets can be used for SIBO management. Dietary modifications can be an integral aspect of a SIBO management plan for short- and long-term support of symptoms. Restrictive elimination diets are not intended to be followed forever; the goal instead should be to implement therapeutic dietary modifications for as little time as possible while SIBO is being addressed and the underlying factors are being managed to support digestive health. Working with a functional nutritionist can help individuals navigate the many SIBO therapeutic diets and implement challenging dietary modifications.
The information provided is not intended to be a substitute for professional medical advice. Always consult with your doctor or other qualified healthcare provider before taking any dietary supplement or making any changes to your diet or exercise routine.
Learn More
Lab Tests in This Article
SIBO - 3 Hour
by
Genova Diagnostics
Breath
The 3-hour SIBO assessment is a non-invasive test that evaluates bacterial overgrowth of the small intestine. This longer test is recommended for patients with slower gastrointestinal transit or constipation.
SIBO/IMO Glucose Breath Test
by
Commonwealth Diagnostics International, Inc.
Breath
*THIS TEST IS $50 OFF FOR THE MONTH OF AUGUST.* This test is used to help diagnose Small Intestinal Bacterial Overgrowth (SIBO) and Intestinal Methanogen Overgrowth (IMO). When bacteria normally found in the large intestine become present in the small intestine, the digestive system may produce excessive hydrogen and/or methane gas, which can cause many gastrointestinal symptoms such as bloating, diarrhea, and constipation. This test comes with a GLUCOSE substrate.
SIBO/IMO Lactulose Breath Test
by
Commonwealth Diagnostics International, Inc.
Breath
*THIS TEST IS $50 OFF FOR THE MONTH OF AUGUST.* This test is used to help diagnose Small Intestinal Bacterial Overgrowth (SIBO) and Intestinal Methanogen Overgrowth (IMO). When bacteria normally found in the large intestine become present in the small intestine, the digestive system may produce excessive hydrogen and/or methane gas, which can cause many gastrointestinal symptoms such as bloating, diarrhea, and constipation. This test comes with a LACTULOSE substrate.
trio-smart SIBO Breath Test
by
Gemelli Biotech
Breath
The trio-smart breath test measures the levels of hydrogen, methane, and hydrogen sulfide in a patient’s breath to determine if any are elevated abnormally. It aids in the identification of small intestinal bacterial overgrowth (SIBO), intestinal methanogenic overgrowth (IMO), and excess hydrogen sulfide. This test comes with a GLUCOSE substrate.
GI Effects® Comprehensive Profile - 1 day
by
Genova Diagnostics
Stool
The GI Effects® Comprehensive Profile is a group of advanced stool tests that assess digestive function, intestinal inflammation, and the intestinal microbiome to assist in the management of gastrointestinal health. This is the 1-day version of the test; it is also available as a 3-day test.
1. Pimentel, M., Saad, R.J., Long, M.D., et al. (2020). ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth. The American Journal of Gastroenterology, 115(2), 165–178. https://doi.org/10.14309/ajg.0000000000000501
2. Cloyd, J. (2023, March 30). An In-Depth Overview of the Three Types of SIBO: Hydrogen, Methane, Hydrogen Sulfide. Rupa Health. https://www.rupahealth.com/post/an-in-depth-overview-of-the-three-types-of-sibo-hydrogen-methane-hydrogen-sulfide
3. Souza, C., Rocha, R., & Cotrim, H.P. (2022). Diet and intestinal bacterial overgrowth: Is there evidence? World Journal of Clinical Cases, 10(15), 4713–4716. https://doi.org/10.12998/wjcc.v10.i15.4713
4. Specific Carbohydrate Diet (SCD). (2022, July 19). Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/23543-scd-specific-carbohydrate-diet
5. Pimentel, M., Constantino, T., Kong, Y.,et al. (2004). A 14-Day Elemental Diet Is Highly Effective in Normalizing the Lactulose Breath Test. Digestive Diseases and Sciences, 49(1), 73–77. https://doi.org/10.1023/b:ddas.0000011605.43979.e1
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Thanks for subscribing!
Oops! Something went wrong while submitting the form.