76% of people with irritable bowel syndrome may have SIBO.
What is SIBO?
SIBO, or small intestinal bacterial overgrowth, is a condition where an excessive number of bacteria colonize the small intestine. This can result from an overgrowth of the resident flora of the small intestine or colonization by microbes typically found only in the large intestine. This imbalance, known as dysbiosis, can cause a range of gastrointestinal symptoms.
Symptoms & presentation
The symptoms of SIBO can vary but commonly include:
Bloating- most common symptom
Constipation, diarrhea, or both
Increased flatulence
Belching
Dyspepsia
Testing for SIBO
Currently, the most common test for SIBO is the lactulose breath test.
This 2-3 hour test involves ingesting lactulose, a type of sugar, and measuring breath samples over time to detect hydrogen and methane gases produced by bacteria. This test can be conducted at home or in a doctor’s office.
But up until this point, at-home tests required you to fill up multiple blow-up bags, fill out paper forms, label the bags, and drop the kit off at the post office.
Until the FoodMarble was developed...
The FoodMarble Aire 2 is a modern device that measures hydrogen and methane gases, providing a convenient way to test for SIBO at home.
Unlike most lactulose breath tests, the FoodMarble device is reusable, allowing for ongoing testing. This is useful for diagnosing, monitoring treatment progress, and checking for SIBO recurrence.
It can be very cost-effective for those with a high deductible and are paying out of pocket for SIBO breath tests, since you buy the device once and can retest as many times as needed.
How accurate is the FoodMarble?
A 2019 study found a 100% concordance between the FoodMarble Aire 2 and the gold-standard clinical devices, indicating high reliability (1).
Intolerance Testing
In addition to SIBO testing, the FoodMarble Aire 2 can also test for intolerances to certain carbohydrates, such as sorbitol, inulin, lactose, and fructose.
These carbohydrates, known as FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols), are poorly absorbed in the small intestine and can ferment in the colon, causing symptoms similar to SIBO.
While these tests aren't yet validated, they may provide valuable insights for individuals following restrictive diets like FODMAP, allowing people to more objectively identify which of the FODMAPS may be triggering symptoms.
Limitations and Recommendations
While home testing with FoodMarble is convenient, you need to work with a healthcare provider. A prescription of lactulose is required for the test, and this can only be obtained from your prescribing doctor.
SIBO is complex and can be challenging to treat without professional guidance. Additionally, other conditions such as IBS, Crohn's disease, and celiac disease can present similarly to SIBO or occur alongside it, making proper medical evaluation and diagnosis crucial.
The Likelihood of SIBO recurrence
Unfortunately, SIBO often recurs, with approximately 45% of patients experiencing a recurrence after antibiotic therapy (2). Addressing underlying factors like immune deficiencies, altered anatomy, and motility disorders is crucial for preventing recurrence and supporting a balanced microbiome.
Questions? Let us know below. We're happy to address them on our social media for everyone to benefit.
Citations:
Shortt, Claire & Brief, James. (2019). PWE-098 A pilot validation study of an at-home hydrogen breath test device. Gut. 68. A219-A219. 10.1136/gutjnl-2019-BSGAbstracts.418.
Lauritano EC, Gabrielli M, Scarpellini E, et al. Small intestinal bacterial overgrowth recurrence after antibiotic therapy. Am J Gastroenterol. 2008;103(8):2031-2035. doi:10.1111/j.1572-0241.2008.02030.x
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