Endo Belly and IBS Awareness Series: How to Test for SIBO

 So, before we get started today, I wanted to let you know that I’m currently off on annual leave, one of my goals this year was to take more time off – well, to basically time off, rather than working through until Christmas! 

And so, the episode you’re hearing today is a replay of a past episode. As it’s IBS Awareness Month, and because so many of us with endo have IBS, I wanted to share with you my most foundational, actionable and informative episodes on endo belly, IBS and SIBO – so every week you’ll get two episodes on this theme, to help raise awareness and to provide you with some actions.

Now because these episodes are old, I may not refer to some of the resources I provide on the endo belly, so I wanted to remind you of the services I provide. So, to start with, I have plenty of other episodes on the endo belly, I have a course called The Endo Belly Course which is specifically for anyone with endo who really struggles with IBS, endo belly or SIBO (here’s the waitlist; I work with 1 to 1 clients; especially those with endo belly or SIBO, and I have lots and lots of articles on Endometriosis News and Endometriosis Net about these topics. And of course, I also   have my Instagram account, which is chock full of SIBO and endo belly info, for those of you wanting to learn more.

Lastly, if you feel you need a little extra support, I am currently running a free Endo Belly Challenge. The challenge ends on April 18th, but if you sign up before May 2nd, you’ll still be able to access all of the challenge, and catch up – and for anyone who takes part, you’ll be invited to a private, free Q&A call with me at the start of May, where you’ll get to ask me all your endo belly questions.

Okay, so without further ado, let’s get to the episode:

It’s finally here! The long awaited episode on how to test for SIBO. Many of you have been contacting me to ask how to get tested or whether you can test at home, so here’s my episode discussing all the ins and outs.

Here’s a breakdown of some of the key points in the episode:

• Hydrogen and methane type SIBO can be detected through a SIBO breath test.

• You can order at-home kits. In my experience, most GPs won’t/can’t order SIBO breath tests and aren’t familiar with it, though GI doctors may be able to and SIBO specialist doctors certainly can.

• A SIBO breath test involves drinking a solution of glucose or lactulose and breathing into a test tube for 2-3 hours. The substrate will feed the bacteria, which will create fermentation, and the gas is then collected in the test tube and measured in the lab in parts per million.

• Tests can be either 2 hours with 8 test tubes or 3 hours with 10 test tubes. 2 hours runs the risk of missing SIBO in a person with slow gut motility, so for that reason, I prefer to go with a 3 hour test.

• Some specialists prefer testing with glucose, others lactulose. I like to use lactulose as glucose is absorbed in the first 1-3 feet of the small intestine and the small intestine is on average 22 ft long! So if the SIBO is further down, a glucose test can miss it entirely.

• A prep diet and overnight fast is required before taking the test. This is a low to no carb diet of meat, fish, eggs, black tea or coffee. There are some allowances for vegans, vegetarians or diabetics. If a patient ate too many carbs, or did the prep test incorrectly it would skew the test results and the test would need to be redone.

• The North American breath testing consensus states that a positive for hydrogen would be a rise of 20 ppm or more (parts per million) from the baseline (the breath before drinking the solution) in the first 90 minutes. A positive for methane would be 10ppm or more in the whole 180 minutes, including the baseline.

• Dr Allison Siebecker, who I trained with, has a slightly different diagnostic range after years and years of working with SIBO clients and consulting with other SIBO specialists. A positive hydrogen for her would be 20ppm in the first 120 minutes, with no rise needed as long as the baseline isn’t the highest number. Methane is 10 within 180 but if constipation was present, the methane would be positive if the reading was 3-9ppm.

• Though hydrogen sulfide SIBO cannot be detected with this test, some H2S patients have a flat line pattern that indicates the presence of H2S. This would be a result of 6ppm or less for hydrogen and 3ppm or less for methane.

• An elevated baseline (so not 0) is normal for methane.

• In the USA, lactulose requires a prescription so you would need to find a doctor who could help you order it.

For a deeper dive and my breakdown on how to take the test itself, have a listen to the show! I really hope this episode helps those of you who are suspecting that SIBO may be the culprit behind your endobelly.

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Sign up to The Endo Belly Course wait list here.

 On March 28th I am running my second Endo Belly Challenge! In this 4-week challenge, you will learn the first steps to identifying the root causes of your endo belly and the initial tools to heal your swelling, gut issues and abdominal discomfort. Every Monday, you'll receive a new email with a little bit of endo belly education and an action to implement that week! This challenge is perfect for anyone who experiences abdominal swelling/bloating, gas, constipation, nausea, diarrhea/loose stools, acid reflux, indigestion or stomach cramps with their endometriosis - and it's entirely free. You can sign up here.

My cookbook This EndoLife, It Starts with Breakfast is out now! Get 28 anti-inflammatory, hormone friendly recipes for living and thriving with endometriosis. Order your copy here.

If you feel like you need more support with managing endometriosis, you can join Your EndoLife Coaching Programme. A 1-to-1 three month health and life coaching programme to help you thrive with endometriosis. To find out more about the programme and to discuss whether it could be right for you, email me at hello@thisendolife.com or visit my website.

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