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Detect bacterial overgrowth that standard testing misses
The Small Intestinal Bacterial Overgrowth (SIBO) breath test measures hydrogen and methane gas production after ingesting a lactulose or glucose solution, revealing bacterial overgrowth in your small intestine — a condition that drives bloating, gas, diarrhea, and malabsorption.
SIBO is wildly underdiagnosed yet affects an estimated 60–80% of IBS patients. Standard stool tests can't detect it because they only sample the large intestine. Breath testing is the gold standard for SIBO diagnosis.
SIBO is the hidden driver behind countless 'IBS' diagnoses. Patients suffer for years on restrictive diets without addressing the root cause: bacteria in the wrong place, fermenting food in your small intestine and creating gas, inflammation, and malabsorption. Gabriel uses SIBO breath test results to design targeted antimicrobial protocols (herbal or pharmaceutical), prokinetic support, and dietary strategies that actually resolve the overgrowth instead of just managing symptoms.
You'll fast overnight, then drink a lactulose or glucose solution and breathe into collection tubes every 15–20 minutes for 3 hours. The test is done entirely at home. Mail the breath samples in the prepaid package. Results arrive in 7–10 business days showing hydrogen and methane levels over time. Upload to Gabriel for SIBO protocol design.
Conventional practitioners read these results through a disease-focused lens — looking for what's broken. Gabriel reads them through a holistic lens — looking for what's out of balance and how to restore it. We see optimal ranges, not just "normal" ranges. We connect findings across all your diagnostics to reveal patterns that siloed specialists miss.
Small Intestinal Bacterial Overgrowth (SIBO) occurs when bacteria that normally live in the large intestine colonize the small intestine. This causes fermentation of food in the wrong place, leading to bloating, gas, abdominal pain, diarrhea or constipation, and nutrient malabsorption.
You drink a sugar solution (lactulose or glucose) and blow into collection tubes at timed intervals over 2-3 hours. Bacteria in the small intestine ferment the sugar and produce hydrogen and/or methane gas, which is absorbed into your bloodstream and exhaled. Elevated gas levels at specific time points indicate SIBO.
Hydrogen-dominant SIBO typically causes diarrhea. Methane-dominant SIBO (now called IMO, Intestinal Methanogen Overgrowth) typically causes constipation. Some people have both. A newer marker, hydrogen sulfide, is associated with diarrhea and sulfur-smelling gas. Treatment protocols differ for each type.
Sensitivity ranges from 60-80% depending on the substrate used. Glucose tests are more specific but only detect overgrowth in the upper small intestine. Lactulose tests cover more territory but have more false positives. Despite limitations, the breath test remains the standard non-invasive SIBO assessment.
Typically $150-250 for at-home collection kits. Labs like Aerodiagnostics, Commonwealth, and Genova offer them. Some gastroenterologists perform in-office testing. Insurance may cover it with a GI referral.
Tell Gabriel your symptoms and health goals. Get personalized diagnostic recommendations backed by evidence, not guesswork.