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Hydrogen Breath Testing

The Hydrogen breath test helps to diagnose either intolerance to sugars or small intestinal bacterial overgrowth (SIBO). It measures how the amount of hydrogen present in your breath changes after you consume a sugar solution. There’s usually very little hydrogen in your breath, therefore having a higher level usually indicates a problem, either from sugar tolerance or bacterial growth in your small intestine. The following are some of the most commonly undiagnosed causes of IBS (irritable bowel syndrome) symptoms that can be identified with the test:

Small Intestinal Bacterial Overgrowth (SIBO)

Genetic Sucrase-Isomaltase Deficiency (GSID)

Lactose Intolerance

Fructose Intolerance 


Scheduling Your Test:

We do not provide read-only testing, which is testing provided without an RDN consultation, where results are sent out to a referring provider. We use on offsite lab that is out of network with most insurances, and have the testing kit sent to our patients' homes. For this reason we must see a patient first in order to place an order for a test, and also to help determine if a patient can get coverage for their test as well as ensure comprehensive treatment. The conditions we test for are primarily managed with nutrition therapy.


Why should I schedule a consult with an RDN to discuss my SIBO result?

SIBO treatment is a 2 phase process that must involve an RDN for appropriate treatment. Phase 1 involves identifying the underlying cause for SIBO which is predominantly dietary and lifestyle factors - diet, stress, food sensitivities, constipation, medication, etc. If these causes go unaddressed before moving to Phase 2 - antibiotic treatment - the SIBO infection will return and/or become treatment resistant following antimicrobial therapy. 

Preparing For Your Test:


Once your dietitian assesses your symptoms, you will be given more detailed instructions on test preparation. If you test positive for a condition, you will be provided with an evidenced based medical diet plan (Medical Nutrition Therapy), which includes detailed instructions for the nutrition management of your condition. We may also refer you to your primary physician or gastroenterologist with your results, requesting review for medication or medical food supplement prescription if necessary. 


The day before the test you will be asked to follow specific dietary guidelines depending on what we will test for. You will be asked to not exercise the morning before the test. You will be given a sugar solution at your appointment to consume prior to initiation of the test. The type of sugar (sucrose, glucose/dextrose, lactulose, etc) will again vary depending on what condition is being tested. Here is a little about each of the most common conditions:

Small Intestinal Bacterial Overgrowth (SIBO):

Like the name suggests, SIBO is where bacteria enter your normally sterile small intestine and begin to colonize. Studies have indicated that potentially up to 80% of patients with IBS may in fact have SIBO, which a Hydrogen / Methane breath test can easily and non-invasively help determine. Treatment of SIBO can be done with a short course of antibiotics provided by your medical professional in addition to Medical Nutrition Therapy. Medication alone will not resolve this. Common symptoms and reasons to test for SIBO: Nausea, Flatulence, Diarrhea, Constipation, Malnutrition, Irritable Bowel Syndrome (IBS), Irritable Bowel Disease (IBD), Leaky Gut Syndrome (Metabolic Endotoxemia), Chronic Fatigue Syndrome, Acid Reflux, Rosacea, Restless Leg Syndrome (RLS), Fibromyalgia, Gastroeseophageal Reflux Disease (GERD), Celiac Disease & Diverticulitis.

Genetic Sucrase-Isomaltase Deficiency (GSID):

Sucrose (common table sugar) is a disaccharide composed of glucose and fructose. It is found in sugar cane and sugar beets, and the fructose moiety is responsible for its characteristic sweetness. The enzyme sucrase (also called sucrase-isomaltase, saccharase or invertase) is present in both animal and plant tissues, and hydrolyzes sucrose into its two component monosaccharides. Some poeple have a genetic mutation where they do not produce this critical enzyme, and therefore feel they need to avoid all carbohydrates to avoid symptoms. This is not necesary as there is a very specific nutrition thrapy for the condition that allows the enjoyment of many carbohydrates and some specific sugars. With prescription enzyme supplementation, symptoms can resolve completely. Symptoms include: Chronic diarrhea, Chronic Abdominal Pain, Gas, Abdominal Distention, Postprandial (post meal) symptoms. 

Lactose (Lactulose) Intolerance / Malabsorption:

Lactose is the sugar found in dairy products such as milk and other dairy foods.  Intolerance to lactose typically leads to symptoms such as Gas, Bloating, Diarrhea or Cramping when dairy products are digested. These symptoms are a result of the body's lack of lactase, an enzyme normally produced by the small intestine that is needed to digest lactose. Milk from certain types of cows have been shown in studies to decrease lactase enzyme production, worsening symptoms. It is important to received Medical Nutrition Therapy recommendations in addition to beginning enzyme therapy available over the counter. 

Fructose Intolerance / Malabsorption:

Fructose can be found in many foods and beverages. Some individuals have digestive issues after ingesting foods / beverages containing this sugar. When the digestive system has difficulty processing fructose, individuals typically complain of symptoms associated with Irritable Bowel Syndrome (IBS). Common symptoms of Fructose Malabsorption or Intolerance may be: Gas, Flatulence, Bloating, Diarrhea, Constipation, Vomiting, Nausea, Stomach Pains. Medical Nutrition Therapy will be provided to aid in avoiding this type of sugar for resolution of symptoms. 


Testing is FREE for Genetic Sucrase-Isomaltase Deficiency. Coverage for other tests varies according to insurance plan. Our lab requires payment up front for testing supplies and laboratory services, however we will help you work with your insurance for potential reimbursement.

The cost per test is $209.99

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