If you saw our last blog post about stool tests, you know we have been heavily focused on gut health here at Clem & Thyme Nutrition! Another tool we have in our gut health repertoire, is testing for Small Intestinal Bowel Overgrowth (SIBO). SIBO is an overgrowth of bacteria in our intestines. We want bacteria in our small intestine but too much can wreak havoc on our health. An overgrowth of bacteria in our small intestines leads to all kinds of discomfort and can manifest in different ways. Many people diagnosed with IBS (irritable bowel syndrome) actually have SIBO.
Symptoms of SIBO are numerous and can include:
- Abdominal pain
- Anxiety
- Belching
- Bloating (gets worse throughout the day)
- Brain fog
- Depression
- Diarrhea
- Constipation
- Fat malabsorption
- Fatigue
- Flatulence
- Food sensitivities or intolerances
- Gastroparesis
- Heartburn/GERD
- Nausea
- Nutrient deficiencies
- Weight loss
- Psoriasis, eczema
There are many medical conditions that are linked to SIBO. At Clem & Thyme, we use a very thorough Patient Health Assessment at your initial appointment, that guides us through visits with clients and assists us in screening for these conditions in conjunction with a symptom evaluation to see who could benefit from testing and treatment.
In addition to these symptoms, risk factors that increase the likelihood of developing SIBO are:
- Low stomach acid
- Poor immune function
- Certain medications
- Bowel surgery or conditions that impacts bowel structure
- Sub-optimal gut motility
- Food poisoning
How do you test for SIBO?
A Genova Diagnostics SIBO breath test! The test is looking to confirm the presence of hydrogen and methane gases which are formed when gut bacteria ferment the testing solution (glucose or lactulose). These gases travel through the bloodstream and are then exhaled.
How much does the test cost?
Clem&Thyme does not mark up the test and all payment is between Genova (the lab) and the client. Unfortunately it’s not cut and dry. The initial payment is $85. Genova will then send a claim to your health insurance company (some insurances) and then bill you for the balance, depending on what your health insurance says you owe. They may not bill you at all, or they could bill you an additional $159. Basically the test could cost anywhere between $85 and $244, depending on what your insurance pays. According to Genova, the average client pays $115 total for the SIBO breath test. The good news… you can use a health savings account to pay for the test.
How it works:
The first step is having a consultation with your Clem&Thyme dietitian, whether you are already a client or totally new to the office. Once we believe a client is a good candidate for the test, we will contact Genova Diagnostics to have a kit mailed directly to your home (or take with you from your in-person appointment). The test is completed in the comfort of your own home, just like the stool test (except you don’t have to hang out in the bathroom for this one!). Clients will then ship the kit via FedEx (Monday-Friday) within 24 hours of obtaining the sample. A billable stamp is included in the kit.
There are some medications, supplements and foods that may impact results, therefore some adjustments may be needed the week prior to testing. The specific diet recommended the 24-48 hours prior to the test is simple (think super bland…. chicken, rice, eggs, plain coffee and tea etc) but your dietitian will review the recommended prep more in depth with you.
Once you have the test kit:
Included in the kit is a requisition form that must be completed (includes client information, insurance and billing sections which we recommend completing first). The night before, read over all instructions for obtaining the sample so you are fully prepared in the morning.
After a 12 hour fast, you will brush your teeth and tongue without using toothpaste or mouthwash. Then mix a lactulose solution into water. You will have 6-8 collection tubes to label, depending on whether you do the two or three hour test. You will breathe into a mouthpiece with each tube separately, every 20 minutes for the two or three hour period. The initial tube will be completed prior to drinking the solution, after which you must drink the solution within five minutes. After the test, package everything up in the bubblewrap bag provided and go to FedEx!
Shipping
Head to FedEx Monday through Friday (within 24 hours of collection) with your bubblewrap bag packed in the FedEx pre-paid shipping bag.
Results take about three weeks and will be sent to your dietitian through a provider portal.
Results Review and Recommendations
With results in hand, your dietitian will develop a plan that will likely include some dietary changes alongside an individualized SIBO protocol. Your protocol will usually include supplements that promote digestive support, gallbladder/liver support, probiotics, antimicrobials and motility agents. It can take several “rounds” of a protocol like this, with each round lasting 4-6 weeks, to resolve symptoms. Unfortunately SIBO can be very stubborn, but with the correct plan… you’ll be able to rid the bacteria from the small intestine.
Some clients may require a prescription antibiotic to eradicate SIBO, in which case, we will be working with the client’s practitioner. But please note, there is research supporting the effectiveness of antimicrobials being as effective as antibiotics. We take things in a case by case basis, like always!
Here is a SIBO-3hr-Sample-Report
As always, reach out with any questions and schedule an appointment if you are interested in getting started! We can see you virtually or at our office in Yellow Springs, just outside of Dayton. 🙂
