Small Intestinal Bacterial Overgrowth (SIBO)

What is the Lactulose Breath Test for SIBO?

In this test, lactulose, which is a non-absorbable sugar solution, is swallowed and hydrogen and methane gases are measured in the patient’s breath at regular intervals.  Gas levels rise as the sugar solution passes through the intestine resulting from fermentation of the sugar by bacteria. If the gas levels rise quickly and to an abnormal level, a diagnosis of small intestinal bacterial overgrowth can be made.

How to prepare for the SIBO breath test:

For accurate test results, certain foods, drinks, supplements, and medicine must be avoided before the test:

  • Wait at least 4 weeks from 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 the test
  • 1 week before the test: Avoid the use of laxatives, stool softeners and/or stool bulking agents (Ex-Lax, Colace, Metamucil, Fibercon) as well as the use of antacids containing aluminum or magnesium hydroxide (i.e. Maalox liquid, Equate, Milk of Magnesia, Rolaids, Mylanta)
  • 2 days before the test: Stop eating high fiber and lactose-containing foods for a full 36 hours before specimen collection. This usually means starting with the dinner meal two nights before doing the test. Please click on the link below for a list of allowed/non-allowed foods and a sample diet.
  • The evening before the test: Eat a light dinner from the attached list of allowed foods (see link below), concentrating on the foods in the “A” list
  • Stop eating and drinking anything other than water at least 12 hours prior to specimen collection
  • The day of the test: Do not drink anything for the first hour of collection. After the first hour, you may drink water only. Continue fasting until you complete the entire test. Do not chew gum or tobacco, smoke, eat breath mints or candy, use toothpaste, nap or exercise vigorously for at least 30 minutes before or at any time during the test.

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