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Serum Laboratory Studies, Stool Test, Breath Test01:30

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Related Experiment Video

Updated: May 7, 2026

Screening and Isolation of C-Glycoside-Cleaving Intestinal Bacteria
06:38

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Published on: February 28, 2025

Breath testing for small intestinal bacterial overgrowth: maximizing test accuracy.

Richard J Saad1, William D Chey1

  • 1Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan.

Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association
|October 8, 2013
PubMed
Summary
This summary is machine-generated.

Diagnosing small intestinal bacterial overgrowth (SIBO) is crucial for treating bowel symptoms. Hydrogen breath testing is a simple, noninvasive method for SIBO diagnosis, though glucose is a more accurate substrate than others.

Keywords:
Glucose Hydrogen Breath TestHydrogen Breath TestLactulose Hydrogen Breath TestSIBOSmall Intestinal Bacterial Overgrowth

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Area of Science:

  • Gastroenterology
  • Digestive Health
  • Microbiome Research

Background:

  • Small intestinal bacterial overgrowth (SIBO) diagnosis is rising due to its link with chronic diarrhea, bloating, and irritable bowel syndrome.
  • Accurate SIBO diagnosis is essential before antibiotic treatment, but current diagnostic methods have limitations.

Purpose of the Study:

  • To evaluate hydrogen breath testing as a diagnostic tool for SIBO.
  • To compare different substrates used in hydrogen breath testing.
  • To identify factors maximizing the accuracy of hydrogen breath testing for SIBO.

Main Methods:

  • Review of diagnostic modalities for SIBO.
  • Focus on hydrogen breath testing using lactulose and glucose substrates.
  • Consideration of hydrogen and methane measurements.

Main Results:

  • Small-bowel aspiration and culture, the gold standard, is invasive, costly, and lacks standardization.
  • Hydrogen breath testing is the simplest, noninvasive, and widely available method for SIBO diagnosis.
  • Glucose is a more accurate substrate than lactulose; lactose, fructose, and sorbitol are not recommended.
  • Measuring methane alongside hydrogen enhances SIBO detection sensitivity.

Conclusions:

  • Hydrogen breath testing is a practical diagnostic tool for suspected SIBO.
  • Optimizing SIBO diagnosis accuracy requires careful patient selection, preparation, and standardized test interpretation.
  • Glucose substrate and combined hydrogen/methane measurement improve breath test efficacy.