At Needles, Herbs & Labs, Dr. Naylous may use Genova Diagnostics’ SIBO Breath Test when a patient has persistent digestive symptoms that may be related to Small Intestinal Bacterial Overgrowth (SIBO) or Intestinal Methanogen Overgrowth (IMO).

Genova notes that research has found a significant association between SIBO and Irritable Bowel Syndrome (IBS), which is one reason non-invasive breath testing may be considered in patients with ongoing gastrointestinal symptoms.

The SIBO Breath Test is a non-invasive test that measures gases produced by intestinal microorganisms after the patient drinks a lactulose solution. The test captures exhaled hydrogen (H₂) and methane (CH₄) over time to help evaluate patterns associated with SIBO and IMO.
 
What Is SIBO?

SIBO stands for Small Intestinal Bacterial Overgrowth, a condition characterized by excessive bacterial growth in the small intestine.

These microorganisms ferment carbohydrates and produce gases that may contribute to symptoms such as bloating, abdominal distention, gas, abdominal discomfort, diarrhea, constipation, and other digestive concerns.

Because these symptoms can overlap with IBS and many other gastrointestinal conditions, breath testing can provide additional information that may help differentiate possible causes of a patient’s symptoms.
 
What Is IMO?

Methane-producing organisms are not technically bacteria, which is why elevated methane is now commonly referred to as Intestinal Methanogen Overgrowth (IMO) rather than methane-predominant SIBO.

Methane patterns may be particularly relevant in patients experiencing constipation or slower intestinal transit, which is why Dr. Naylous reviews both hydrogen and methane results when interpreting the test.
 
What the SIBO Breath Test Measures

Genova Diagnostics’ SIBO profiles measure:

• Hydrogen (H₂)

• Methane (CH₄)

• Changes in gas levels over time

• Patterns that may be consistent with SIBO or IMO

Patients consume a lactulose solution and then collect breath samples at timed intervals. The changes in hydrogen and methane levels throughout the test provide information about intestinal fermentation patterns.

Genova’s SIBO profiles follow interpretation guidelines based on the North American Consensus Guidelines published in the American Journal of Gastroenterology.
 
2-Hour vs. 3-Hour Testing

Genova Diagnostics offers both 2-hour and 3-hour SIBO Breath Test profiles.

The 3-hour profile may be particularly useful for patients with slower gastrointestinal transit or constipation because it provides information about gas production over a longer period of time.

Genova also notes that certain flatline patterns extending into the third hour may raise the possibility of gases not directly measured by the standard hydrogen and methane test, such as hydrogen sulfide. These findings must be interpreted within the broader clinical picture and are not diagnostic on their own.
Symptoms Commonly Associated With SIBO

A SIBO Breath Test may be considered for patients experiencing:

• Bloating or abdominal distention

• Excessive gas

• Abdominal pain or discomfort

• Diarrhea

• Constipation

• Alternating constipation and diarrhea

• Dyspepsia or upper digestive discomfort

• Digestive symptoms after eating

• Persistent food-related bloating

• Irritable Bowel Syndrome (IBS)

• Recurrent digestive symptoms after previous SIBO treatment

Not every person with these symptoms has SIBO, which is why testing and clinical interpretation are important.
 
Conditions That May Be Associated With SIBO

Genova Diagnostics notes that SIBO may occur alongside a number of gastrointestinal and systemic health conditions, including:

• Irritable Bowel Syndrome (IBS)

• Inflammatory Bowel Disease (IBD)

• Celiac disease

• Diabetes

• Fibromyalgia

• Rosacea

• Parkinson’s disease

• Obesity

The presence of one of these conditions does not mean that a patient has SIBO. Dr. Naylous considers the entire clinical picture when determining whether breath testing may be appropriate.
 
Why Does SIBO Develop?

When a SIBO Breath Test is positive, Dr. Naylous also considers why bacterial or methanogen overgrowth may have developed in the first place.

Risk factors described by Genova Diagnostics include:

• Intestinal motility disorders

• Chronic pancreatitis

• Structural or anatomical gastrointestinal issues

• Previous gastroenteritis

• Immune dysfunction

• Reduced digestive secretions

• Reduced stomach acid

• Reduced pancreatic enzyme activity

• Reduced bile acid activity

• Proton pump inhibitor (PPI) use

• Ileocecal valve dysfunction

Identifying potential contributing factors can be important because treatment may be less effective if the underlying reason for recurrence is never addressed.
 
Looking Beyond the Test Result

A positive SIBO Breath Test does not exist in isolation.

Dr. Naylous considers the results alongside the patient’s:

• Symptoms

• Bowel habits

• Diet

• Medical history

• Digestive function

• Medications

• Previous treatments

• Nutrient status

• Stool testing when appropriate

• Other laboratory findings

Long-standing bacterial overgrowth may also affect nutrient absorption and gastrointestinal function, so additional evaluation may sometimes be appropriate depending on the patient’s symptoms and history.
 
Who May Benefit From a SIBO Breath Test?

Testing may be considered for patients with:

• Persistent bloating

• Excessive gas

• Abdominal distention

• Constipation

• Diarrhea

• Alternating bowel habits

• Abdominal discomfort

• Symptoms that worsen after meals

• Persistent digestive symptoms despite dietary changes

• IBS-like symptoms

• A history of gastrointestinal dysfunction

• Previously treated SIBO with recurrent symptoms

• Risk factors that may predispose someone to bacterial overgrowth

Not every patient with digestive symptoms requires a SIBO Breath Test. Dr. Naylous determines whether testing may provide useful information based on the individual clinical picture.
 
How It Works

After your consultation, Dr. Naylous will determine whether a Genova Diagnostics SIBO Breath Test is appropriate and whether the 2-hour or 3-hour profile best fits your clinical needs.

The test is completed using an at-home breath collection kit. Patients follow specific preparation instructions before testing and then consume the provided lactulose solution.

Breath samples are collected at timed intervals and returned to Genova Diagnostics for analysis.

Once the results are available, Dr. Naylous reviews the hydrogen and methane patterns in detail and discusses the findings with you during a follow-up consultation.

Recommendations may then be individualized based on your results, symptoms, digestive history, and overall health picture and may include nutrition, targeted supplementation, Chinese herbal medicine, lifestyle strategies, acupuncture, or additional evaluation when appropriate.

A More Complete Look at Digestive Health

The purpose of a SIBO Breath Test is not simply to determine whether someone has “too much bacteria.” It is to gather additional information about where intestinal fermentation may be occurring, which gases are being produced, and whether those findings fit with the patient’s symptoms and digestive history.

At Needles, Herbs & Labs, Dr. Naylous uses SIBO breath testing as one part of a broader approach to understanding persistent digestive symptoms and identifying factors that may be contributing to the patient’s overall gastrointestinal health.