Small Intestinal Bacterial Overgrowth (SIBO) occurs when there is an abundance of bacteria present in the small intestine. The small intestine is crucial for the digestion and absorption of nutrients. However, when there is an imbalance with an excess of bacteria, often stemming from migration from the large intestine, it disrupts the digestive process. This disturbance can manifest in various health issues you might currently be facing. Intriguingly, research suggests that as many as 80% of individuals diagnosed with Irritable Bowel Syndrome (IBS) may actually have underlying SIBO.

Low or no stomach acid
Pancreatic enzyme and/or bile insufficiency
Hypothyroidism/Hashimottos
Chronic stress
Infections (viral/bacterial/parasitic)
Chronic constipation
GI tract dysfunction (ileocecal valve)
Nerve dysfunction

Bloating
Gas/belching
Stomach distension/pain
Constipation/Diarrhea
Food intolerances
Fatigue
Brain fog
Skin problems
Moodiness

SIBO can lead to many diseases, disorders and health ailments such as:

Alzheimer's
Parkinson's
Multiple Sclerosis
Acid reflux
Fibromyalgia
Chronic Fatigue Syndrome
Inflammatory diseases
Irritable Bowel Syndrome
Type 2 diabetes
High Blood Pressure
Brain Fog
Autoimmune disease
Leaky Gut
Acne
Restless Leg Syndrome
Weight loss/Weight gain

The SIBO breath test involves a 24-48 hour prep diet. This means 24-48 hours prior to your test.

During the preparation phase, refrain from consuming all non-essential medications, supplements, and probiotics. This includes over-the-counter pain relievers, allergy medications, and antacids. If unsure about the necessity of a medication, consult your prescribing physician. The objective is to deprive bacteria of nourishment for optimal test results. Bacteria thrive on plant products and sugars; therefore, adhere strictly to the following allowed foods during the prep diet:

• Unprocessed meat, poultry, fish, and seafood (non-cured or brined)
• Plain, steamed white rice (Basmati or Jasmine only)
• Eggs
• Clear meat broth (free of bone/cartilage or vegetables)
• Fats/oils (coconut/olive/vegetable oils, butter, or lard)
• Salt and pepper (without additional herbs/spices)
• Weak black coffee and/or weak black tea (unsweetened, without cream; herbal or green teas are not permitted)
• Plain water (without minerals or additives)

No. Any changes to the diet can affect the results of the test. The manufacturer of the SIBO test created the prep diet based on their research and testing. Only the things on the prep diet are allowed to get the cleanest results for the SIBO test.

No. If you do not eat grains, for example, do not consume the rice. If you do not eat eggs, then do not start just for this diet. Eat things on this list, but only of what you would normally eat.

Many practitioners may will modify your diet to what they feel is the best test for you. We at SIBO CLINIC CANADA only go by what the manufacturer of the SIBO test (Qiuntron) has worked with to create the guidelines for the test. If your practitioner has a specific modification (such as hard cheeses) then you must discuss it with them, as we cannot give advice about foods outside of the manufacturer’s guidelines. However, although cheese is a form of dairy, and dairy is not on the list of foods to consume because of the latose-containing sugar, hard aged cheeses have minute tracres of lactose, and the more aged the cheese, the less lactose it contains. If you do find the prep diet far too constrictive, and feel the need to have cheese, please proceed with caution and make sure the cheese is non-processed aged cheese.

The only grain acceptable on the prep diet is plain, white Basmati or Jasmine rice because they have the lowest glycemic index of all rice. Other rice/grains have a higher level of fiber and macromolecules that SIBO bacteria like to eat. Any substitutions can give inaccurate test results. If you normally do not eat rice, do not eat any during the prep diet.

The SIBO prep diet specifically cuts out plant products and sugars in order to starve the bacteria for a day prior to taking the test, which will give you the most accurate results. If you do not adhere to the diet, the bacteria may not react during the test, leading to possible false negative results. If you do not normally consume poultry/meat/eggs, please consult with nutritional expert to determine your options.

Regular bone broth is often cooked with cartilaginous bones or meat.  When cooked, polysaccharides (specifically glucosaminoglycans or GAGs) from the cartilage leech into the bone broth and can feed a bacterial overgrowth and therefore be problematic for people with SIBO.

It is important that if you consume meat broth for the prep diet, it must be made from ONLY the meat. There cannot be any bone or cartilage included, and it cannot have any vegetables or herbs (aside from salt and pepper) in it. Most store bought broths have ingredients that are not appropriate for this prep diet, so homemade broth is the best decision.

Any meat ingested must be made without any added sugars/brines/cures/etc. to avoid contaminating the prep diet. Avoid meats like deli-meat, lox, and pre-prepared meats that have any other herbs and spices besides salt and pepper. Meats like sausage usually have other herbs or sugars in them and should be avoided during the prep diet.

The sashimi fish is fine on the prep diet, when eaten alone and without sauce. The rice in Nigiri is usually made with sugar-based binders to make it stick together better, and thus should be avoided on the prep diet. The only exception is home-made Nigiri with steamed white rice and no sauces. Sushi rolls are very much to be avoided.

If you are a smoker, of tobacco or cannabis, there is no recommendation to stop use during the prep diet. However, do not smoke anything for at least one hour prior to taking the breath test, or during the time of the test (4 hours total). If you ingest cannabis in edible form, it must be avoided during the prep diet. Smokeless tobacco (chew) should be avoided during the prep diet and prior to the test as well. Avoid all alcohol during the prep diet.

We do not test for Hydrogen sulfide at this present time. It is coming soon. However, please read the following information of what we see as current

1. Cost: H2S SIBO testing can be more expensive than traditional hydrogen and methane SIBO testing. The cost can vary depending on the specific test and the laboratory. The higher price might concern individuals trying to manage their healthcare expenses.

2. Accuracy: H2S SIBO testing methods are still evolving, and accuracy and reliability may have limitations. Some tests have a higher false positive or false negative rate than hydrogen and methane testing. This can make it challenging to diagnose H2S SIBO based solely on testing results confidently.

3. Drawbacks of H2S Testing:
Limited Research: Compared to hydrogen and methane SIBO, more research and clinical experience with H2S SIBO needs to be done. This can make it harder to interpret the results and understand the implications of a positive or negative test.
Interpretation Challenges: Interpreting H2S SIBO test results can be more complex. Various bacterial strains can produce different levels of H2S, and the significance of those levels can sometimes be clarified. This complexity can lead to uncertainty in treatment decisions.
False Positives/Negatives: As mentioned earlier, accuracy can be a concern. False positives and negatives can lead to misdiagnosis or delay appropriate treatment.
Treatment Approach: The treatment approach for H2S SIBO might differ from traditional hydrogen and methane SIBO. However, due to the evolving nature of H2S testing and limited clinical guidelines, healthcare practitioners might have varying approaches to treatment.

4. Advantages of Hydrogen and Methane Testing:
Established Methods: Hydrogen and methane SIBO testing methods have been used longer and are more commonly found in clinical practice.
Clearer Guidelines: Treatment protocols for hydrogen and methane SIBO are better defined due to the larger body of research and clinical experience.
Cost: Hydrogen and methane testing is generally more cost-effective, making it more accessible for individuals.