What is the Best SIBO Test?

In this episode of The Dr. Hedberg Show, I interview Gary Stapleton of Aerodiagnostics Laboratory answering the question, "What is the best SIBO test?"  We covered a lot of ground about the ins and outs of SIBO breath testing including the best methodology, glucose vs. lactulose, how to properly perform the test, proper test interpretation, hydrogen sulfide, when to retest and much more.

Gary is the founder of Aerodiagnostics Laboratory which I personally use in my practice and highly recommend to everyone who wants the most accurate SIBO test on the market today.  Combine that with the best customer service and support and it's a no-brainer to use them for your SIBO testing.
Below is a transcript of the entire interview with important links at the end:
Dr. Hedberg: Okay. Well, welcome, everyone. This is Dr. Hedberg and welcome to "The Dr. Hedberg Show." I'm excited today to be talking to Gary Stapleton. And Gary is the founder of Aerodiagnostics Laboratory. And this is the laboratory that I use for small intestinal bacterial overgrowth testing. Their lab offers non-invasive hydrogen and methane breath testing. It's the lab I've been using to test for SIBO because the quality is really unparalleled in the SIBO world and I've been very, very pleased with the quality of the results I've been getting and the customer service. So we're going to be talking about some really interesting items today about SIBO and SIBO testing. So, Gary, welcome to the program.

Gary: Oh, thank you, Dr. Hedberg. I really appreciate joining today and I look forward to discussing SIBO and breath testing, hydrogen and methane breath testing with the audience.

Dr. Hedberg: Excellent. Yeah, it's good to have an expert like you here because this is really a hot topic. I mean, the prevalence of SIBO is continuing to grow and we're seeing it more and more. And then, of course, our IBS population really struggles with SIBO, for the most part. So why don't you start by just talking to us about hydrogen and methane breath testing and how it works in the diagnosis of SIBO?

Gary: Yes, so thank you. And please feel free to interject if there's something that I've said or am in the process of saying that might be beneficial as well. So hydrogen and methane gas, for those listening that aren't aware, are not produced by the body. Hydrogen and methane gases are produced by bacteria that is fermenting. So the way that the test works and why it's so incredibly important to prepare correctly, to use the right devices correctly and to administer and ensure that your devices are operating correctly, to ensure that we're measuring hydrogen and methane gas appropriately, it all begins with the preparation. And then, if you prepare correctly, which means you're moving food from the GI tract, there...even if there's bacteria, there's no gas being produced because the bacteria, if it's there, needs to be fed to ferment and to produce this gas.

So if you have bacteria in your small intestine and you're not supposed to have bacteria in your small intestine, I believe it should be less than 103 colony-forming units in the small intestine. If there's bacteria there and you've prepped, which means you've removed all food, your baseline breath sample should be relatively low to no gas because, again, the bacteria's there, it's not being fed.

Now, after that baseline sample, you ingest either glucose or lactulose as a substrate that has been validated to ensure appropriate measurement of gas levels inhalation of small intestinal bacterial overgrowth. When you ingest either that glucose or lactulose, that is a food source. And that food source will now feed bacteria, if it is there. That bacteria will ferment or rot and the gas that's produced, either hydrogen or methane, will diffuse through the blood and exit via the lung air.

I'll deflect for just a moment and say everyone is aware that there's a third gas. It's called hydrogen sulfite gas.