SIBO Breath Testing Instructions

SIBO Breath Test Instructions

Small Intestinal Bacterial Overgrowth (SIBO) is a condition in which there is an excessive amount of bacteria in the small intestine. The SIBO breath test is a non-invasive test that measures the levels of hydrogen and methane gases in your breath, which can indicate the presence of bacterial overgrowth in your small intestine.

Obtaining accurate test results is crucial for diagnosing and treating SIBO. This guide will provide detailed instructions on how to prepare for and conduct the SIBO breath test, as well as highlight the importance of avoiding certain foods, medications, and supplements that can interfere with the test's accuracy.


Before taking the SIBO breath test, there are several general considerations to keep in mind. It is recommended to wait a certain period after undergoing certain procedures or taking specific medications.

Preparing for the SIBO breath test involves avoiding specific medications and foods, observing a fasting period, and considering other important factors.

SIBO Breath Test Preparation Guidelines

According to Dr. Siebecker and the North American Consensus, it is essential to pause antibiotics, including herbal ones, four weeks before the test. If retesting post-antibiotic (or herbal) treatment for SIBO, you may take the test the next day.

However, if you have recently experienced extreme diarrhea, had enemas, a colonoscopy, or a barium examination, please wait 14 days before testing, unless your doctor advises otherwise. Also, avoid bismuth preparations (Pepto Bismol), laxatives, or stool softeners (Colace, Milk of Magnesia, Ex-Lax), or stool bulking agents (Metamucil or Citrucel).

In the 4-7 days before the test

avoid probiotic supplements or foods containing them (e.g., yogurt, kombucha, kefir), stop taking prokinetics and laxatives, including high-dose vitamin C and magnesium for laxative purposes.

Glycerin suppositories are permitted. Also, discontinue fiber supplements like psyllium, flaxseed, etc., stop drinking coffee if it's needed to produce a bowel movement, and stop taking digestive aids like enzymes or hydrochloric acid (e.g., Betaine HCI). If you can't go without it, stop the test preparation and consult your therapist or doctor.

24-48 hours before the test

start the Preparation Diet, which includes a 12-hour fast after finishing your last meal. For example, if you plan to take your test at 7 AM, you should finish your last meal by 7 PM and avoid non-essential medications and dietary supplements.

During the first 12 hours

of diet restriction, consume only ideal foods like meat and eggs with little fat, and avoid carbs like nuts, seeds, fruit, veggies, grains, beans.

You can choose to fast or consume only specific foods like baked or fried chicken, turkey, fish, clear meat broth (but no bone broth, no vegetable broth, no onion, garlic, or veggies inside), eggs, small amounts of fats/oils (olive oil, coconut oil, butter), and carbs only if tolerated/desired (freshly cooked white rice, white bread, or white pasta only if those things do not aggravate symptoms).

Note: Avoid foods that personally cause symptoms, even if they're listed as allowed.

For vegetarians, eggs, starches, and hard-aged cheese (no lactose left) are permitted. Vegans could do a one-day water fast, white rice/white bread, or the same as diabetic with few little bits of fruit & vegetables that are not very fermentable, or 2/3 cup plain, firm tofu per meal (not silken tofu due to higher fermentation). Diabetics may need adjustments like half a banana or a small carrot for blood sugar balance.

During the next 12 hours/night before diet

restriction, consume only non-carbonated water, have an early dinner, and fast for 12 hours before the test, during which only plain water is permitted.


  1. Always consult your healthcare professional or doctor before implementing these guidelines, especially if on medication.
  2. Don't stop medication without doctor approval.
  3. Diabetics may need adjustments like half a banana or a small carrot for blood sugar balance.
  4. Pregnant women and diabetics should review these guidelines thoroughly with their healthcare professional.

The goal of these guidelines is to ensure accuracy in the SIBO test by minimizing fermentable food presence.

Day-of-Test Preparations:

  1. Timing: Conduct the test first thing in the morning. Get up at least one hour before starting the test.
  2. Consumption: Drink only plain, still water. Any other foods or drinks can result in false readings and potentially necessitate a test redo.
  3. Oral Care: Brush your teeth thoroughly and rinse out all toothpaste, ensuring none is swallowed. Avoid mouthwash or chewing gum.
  4. Medications: Skip any non-essential medications as they could skew results (please discuss with your healthcare provider). Essential medications can be taken with water, but avoid those that impact bowel function. Diabetics should consult their doctor regarding any medication adjustments.
  5. Other Guidelines: Avoid denture fixatives/adhesives, refrain from smoking or exposure to smoke/vaping, skip strenuous exercises before and during the test, and stay awake throughout the testing duration.

NOTE: Should you be on medications or special diets that conflict with these guidelines onsult your healthcare professional for possible adjustments.

Test Procedure

The SIBO breath test procedure involves collecting breath samples in bags at specific intervals after drinking a sweet liquid that contains either lactulose or glucose. You will need to collect breath samples every 30 minutes for a total of 1.5 to 3 hours. Depending on the type of test.

It is essential to report any symptoms experienced during the test and to avoid certain activities such as smoking, exercising, or lying down/sleeping during the exam.

Detailed Testing Process:

  1. Baseline Sample: To begin the test, take a baseline breath sample by breathing into a test tube with a straw or a sample collection device. This sample will serve as your baseline reading.
  2. Consumption of Test Solution: Next, consume the entire test solution (usually glucose or a synthetic sugar) provided by your healthcare professional or the test manufacturer within 5 minutes.
  3. Subsequent Samples: Every 30 minutes for the next 1.5 to 3 hours, breathe into a new text tube to provide additional breath samples. Record the time each sample is taken.
  4. If you experience any symptoms during this time, such as bloating, abdominal pain, diarrhea, etc., make a note of the symptoms and the time they occurred.
  5. End of Test: At the end of the test, ensure all breath samples are labeled correctly and return them to the laboratory for analysis as instructed.

Post-Test Instructions:

  1. Resume regular diet and medication intake as recommended by your healthcare provider.
  2. The results usually take around 1-2 weeks to be processed and analyzed by the laboratory. Your healthcare provider will discuss the results and any necessary treatment or further testing with you.

Note: Make sure to follow any additional instructions provided by your healthcare professional or the test manufacturer.

The instructions above are general guidelines and may vary based on individual health conditions and specific test kits used. Always consult your healthcare professional for personalized instructions and follow the manufacturer's guidelines provided with the test kit.

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