Sunday, 13 October 2013

Breath Testing for SIBO, Fructose Malabsorption and Lactose Intolerance

In my quest to find the elusive roots to my daily stomach discomfort, headaches, brain fog, energy dips and general roller coaster nature, I opted to try the breath testing route for SIBO, fructose malabsorption and lactose intolerance. I have a suspicion SIBO will come back positive (small intestinal bacterial overgrowth) as many of my symptoms are listed under descriptions of the infection, and despite 2 heavy doses of antibiotics to eradicate helicobactor pylori and 2 parasites… symptoms continue. I suspect fructose malbsorption due to the pain high FODMAPs foods generally cause me, as well as random spurts of nausea. I chose to test lactose out of curiosity - as while I don’t have dairy as a rule, I am a fan of grass fed butter and haven’t narrowed down if/how it affects me.

This option isn’t necessary for everyone, and I dare say it’s expensive at $130 per test plus a control test, but I haven’t had success on a traditional elimination + reintroduction diet. Many of my symptoms are also subtle and seem to be disconnected (sometimes extra dairy gives me break outs, sometimes not, sometimes I notice pain after eating onions but seem to be ok with garlic, sometimes sugar makes me bloat, sometimes not etc). This is also the only real way of testing for SIBO and I’m the kinda girl who needs to see something on paper before she decides to eliminate ALL carbohydrates from her diet to heal her gut completely.

The procedure is pretty straight forward: you eat a restricted diet for 2 full days before testing, fast the night before the test, drink a super sugary solution then for the next 3 hours you have to blow into a little silver bag every 20 mins and avoid all food and liquid. Unfortunately said solution can make you feel a bit crap, especially if it’s a solution for something you can’t tolerate! (Fructose was the worst culprit for me). There are also a few extra guidelines around pre-test avoidance of probiotics, antibiotics, colonics, supplements and pain killers. This is what a test kit looks like through Stream Diagnostics



I opted for this company as it was a little bit cheaper than the place here in Perth and I could also order the kits to do the testing in the comfort of my own home. Spending 2 hours fasted and cranky in some sterile health office didn't seem too appealing. As far as I know they send internationally and their customer service is exceptional with prompt email replies and a hotline you can call up until 10pm EST with any questions.

From their website:

At the start of each of these breath tests, you will be given an inflatable bag to create a ‘baseline’ breath sample. This sample is processed and the amount of methane and/or hydrogen in it will be recorded. You will then have a sugar drink, after which you will create further breath samples at 20 minute intervals for the next 2 hours at minimum.
As you will have followed the diet for a full 2 days before each in clinic and Home Kit test, this will have lowered the level of bacterial activity in your digestive tract to as close to zero as possible. The diet is designed to lower bacterial activity through a lack of sugars which may be causing you symptoms – namely Fructose, Lactose and Sorbitol.
The baseline breath reading before your drink will provide your ‘resting’ hydrogen and methane content. Then, when you have the sugar drink, this travels through your intestinal system over the next hour or so. If the sugar passes through the small bowel with minimal or no absorption through the gut wall, it will carry on to the large bowel, where the bacteria will begin feeding on the sugar, converting it in part to a gaseous response, which is able to be read via your exhaled breath content.
I sent my first lot of tests away on Thursday, so with any luck I’ll have more clarity by the end of the month :-)

Links:

SIBO basics
Pre-Test Diet
Stream Diagnostics

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