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The hydrogen breath test is generally agreed to be the best method to test for small intestinal bacterial overgrowth (SIBO).  However, there was disagreement on the how to the timing of the test, the size of the glucose dose, and how to calculate the result.  To address these problems a group of highly regarded gastroenterologist gathered to come to a consensus of on the best practices.  The group made the following recommendations: 1) the duration of the SIBO test should be 90 minutes, 2) the dose of glucose should be 75 grams, and 3) a change of 10 ppm over baseline for methane gas is a positive result for SIBO.

This study evaluated whether there was a link between subclinical atherosclerosis (hardening of the arteries) and small intestinal bacterial overgrowth (SIBO).  Thirty nine patients were enrolled and received a glucose hydrogen breath test to assess for SIBO.  In the group 30.8% were positive for SIBO. Atherosclerosis was determined using  levels of dephosphorylated-uncarboxylated matrix Gla-protein and pulse-wave velocity. There existed a statistically significant correlation between SIBO and atherosclerosis leading the researchers to conclude that SIBO testing might be a good screening tool for early stage atherosclerosis.

It is possible that prolonged use of proton pump inhibitors (PPIs) may increase the risk of small intestinal bacterial overgrowth (SIBO). This is because chronic acid suppression may alter the intraluminal environment leading to growth of bacteria in the small intestine. There have been numerous studies that examined the risk of SIBO in adults taking PPIs but the results have been inconclusive. This studies goal was to determine the incidence of SIBO in children who regularly use the PPI’s. The study enrolled 83 children of whom 56 were taking PPI and the rest used as controls.  The result was 9% of the children taking PPI’s tested positive for SIBO while 4% of the controls tested positive for SIBO.  While the study lacked statistical significance the results bear out that SIBO should be at least considered in children taking PPI’s over an extended period of time.

Here is the link to a worthwhile TV news story about small intestinal bacterial overgrowth (SIBO and using the hydrogen breath test to detect its presence.

It has been hypothesized that people with multiple sclerosis (MS) may have a high prevalence of small intestinal bacterial overgrowth (SIBO).  The reason is unknown but some researchers believe that a problem in the gastrointestinal microbiota can cause MS while others believe the affects of MS make these patients more susceptible to SIBO.  A recent study conducted in China sort to examine the prevalence of SIBO in MS patients.

This updated information confirms the important role small intestinal bacterial overgrowth (SIBO)  has in rosacea.   It confirms that the incident of SIBO is very high (46%) but most importantly successful treatment of SIBO with antibiotics like rifaximin leads to clinical remisison that lasted throughout the 3 year follow -up period.

A new study may explain why people who do not have celiac disease or wheat allergy nevertheless experience a variety of gastrointestinal and extra-intestinal symptoms after ingesting wheat and related cereals. The findings suggest that these individuals have a weakened intestinal barrier (leaky gut), which leads to a body-wide inflammatory immune response.

A recent study examined whether Proton Pump Inhibitors (PPI) such as Prilosec, Prevacid, Nexium and Protonix can cause small intestinal bacteria overgrowth.  The concern was that acid blockers change the natural flora of the small intestine leading to bacterial growth.   The conclusion was no – there was no correlation between taking PPI’s and getting SIBO.

A recent study presented at the British Society of Gastroenterology Annual Meeting.found that irritable bowel syndrome patients experienced greater benefits from a low FODMAP diet if they had a positive fructose breath test. The researchers found that irritable bowel syndrome patients that had fructose malabsorption had more symptom relief from a low FODMAP diet as compared to patients who tested negative. We offer a home based hydrogen breath test for fructose malabsorption.

Food allergies are on the rise.  Why the increase has occurred is unclear but understanding your situation is important to maintain good health. That said, people also tend to overestimate the extent of food allergies, according to a 2006 piece in the scientific journal EMBO Reports. “The rates of perception of food allergies are often up to four times greater than the rates of true food allergies, because people confuse allergy with intolerance or even cases of mild food poisoning.”