FAQ

Is it difficult to conduct the test?

No. The test is simple to administer, and there are detailed test instructions with step-by-step explanations. A brief description of the test procedure is provided in the follow-up questions. The description included in the test kit is even more detailed.

Can I take the test alone?

Yes. The test can be performed at home. No doctor's visit or appointment at a doctor's office is required.

Is there a guide to the test

Yes. A printed step-by-step test guide is included in the test kit.

How does the test detect SIBO?

The breath test measures hydrogen and methane gases in the breath in response to drinking a sugar solution. The sugar solution is usually lactulose (consisting of fructose and galactose) or glucose. When SIBO is present, bacteria begin metabolizing lactulose in the small intestine before it reaches the large intestine, leading to an early increase in gas production. These gases enter the bloodstream, are exhaled through the lungs, and measured by us.

How is the test performed

A sugar solution (15 ml) is mixed with water and drunk. Breath samples are then collected using a mouthpiece and vacuum tubes that store the air and make it transportable. These samples are sent back to the laboratory for analysis. Detailed step-by-step test instructions are included with your test kit.

Are hydrogen (H2) and methane (CH4) measured?

Yes. This is the only way the test delivers the most reliable results. Common breath tests often only measure hydrogen, so SIBO often goes undetected in people who produce methane (approximately 30% of the population).

Why does Sibolab prefer to use lactulose?

Lactulose provides more reliable results. Glucose is absorbed from the first segment of the small intestine and can only detect bacterial activity there. Lactulose, on the other hand, migrates all the way to the large intestine and allows detection all the way to the posterior segment.

Can I use glucose instead of lactulose for my test?

As explained in the previous question, there are good reasons to use lactulose. However, if you would prefer to use glucose, you can use the "Special Instructions to the Seller" field during the ordering process and request glucose there. Simply write: "I would like to use glucose instead of lactulose."

How long does the test take?

The test lasts 180 minutes (3 hours) - preparation time is not included!

What is included in the test kit?

Test instructions, 10 vacuum glass tubes, 1 mouthpiece with breathing bag, sugar solution (lactulose or glucose), address and postage label for return shipping within Germany, patient information to be able to assign and carry out the test.

What do I need to consider before the test? (Test preparation)

All preparation suggestions must be discussed with your therapist in advance.

In general:

1 month before the test

Wait at least 4 weeks before testing after: antibiotic therapy¹, colonoscopy, colonic irrigation, and X-ray examination with oral contrast medium.

1 week before the test – take a break:

• Prebiotics, probiotics and probiotic products (e.g. yogurt and fermented products)
• Antifungals
• Herbal antimicrobial products (“herbal antibiotics”)¹

24 (48) hours before the test

• Strictly follow the preparatory diet² (starting 48 hours in case of constipation; details in the next question).
• Stop taking: laxatives, stool softeners, other digestive aids, proton pump inhibitors (PPIs), dietary supplements.

12 hours before the test

• Fast for 12 hours (water only).
• If possible (only after consultation): avoid non-essential medications.

1 hour before & during the test

• Brush your teeth with water only (without toothpaste).
• No smoking (including passive smoking).
• Wake up at least 1 hour before the test; do not sleep during the test.
• No sporting activities.

Note ¹: For follow-up tests to monitor the success of SIBO therapy with (herbal) antibiotics, there is no need to wait; testing can be performed immediately after therapy.

What can I eat the day before the test? (Preparatory diet)

Purpose: To prevent fermentation of foods, which can distort measurement results. Start 24 hours in advance (48 hours in case of constipation). Please only eat the following:

Permitted foods

• Baked/roasted chicken, fish or turkey (with salt & pepper)
• Olive or coconut oil (1 tbsp for cooking)
• Steamed white rice (basmati/jasmine)
• eggs
• Clear chicken or beef broth (boneless, without vegetables)
• Only white bread
• Pure table water (not mineral water)
• The morning before: 1 cup of black tea or coffee (no sugar, milk, or sweeteners). On the day of the test: just water.

Example plan

• 08:00–20:00 : Diet (12 hours)
  Breakfast: scrambled eggs + a slice of white bread
  Lunch: Salt/pepper chicken + white rice
  Evening: Fish with salt/pepper + white rice
  Drinks: still water
  
• 8:00 PM–8:00 AM : Fasting (12 hours) – water only; test begins at 8:00 AM. Drink only moderate amounts of still water during the test.
  

Important: Guidelines vary by therapist/laboratory; study results are inconsistent. Adjustments by practitioners are possible.

I've already taken a hydrogen (H2) breath test. Is another test at Sibolab worthwhile?

If any of the following questions are answered with “no,” a new test is recommended:

• Has it been tested for methane ?
• Has it been tested with lactulose ?
• Was the test carried out at least 140 minutes after the sugar solution?
• Was the test preparation adhered to?
• Was the test performed correctly ?

Which medications do I need to stop taking and how early before the test?

The test preparation information includes information about medications.

Is the test alone a reliable test for SIBO?

Unfortunately, there is no perfect test. False positive results are rare and usually caused by improper preparation or collection. Almost all false negative results are avoided by measuring methane in addition to hydrogen.

How quickly do I have to return the test?

Send the test within two business days of taking it. For example: Test on Monday → return by mail by Wednesday at the latest.

Is delivery free?

Yes, shipping within Germany is free – including return shipping to the lab. A shipping label is included.

Is delivery possible outside of Germany?

Yes, we also ship internationally. However, shipping is only free within Germany.

• EU & Switzerland: 9.99 € expense allowance
• Non-EU: 19.99 € expense allowance
• Customer bears return shipping & costs.
  Breath samples are stable for at least 14 days after collection; please return them promptly.

Will my health insurance cover the test?

Unfortunately not. This is an individual health benefit. However, it may be worth checking with your insurance provider.

How do I cancel/revoke my order?

Please send an email with the cancellation form and order number to info@sibolab.eu . Once we receive the returned item safely and undamaged, we will cancel the invoice. Please note the cancellation policy.

What payment options do I have?

Paypal, credit card (Visa, Mastercard, American Express, Maestro), Klarna (Sofort, purchase on account), Sofortüberweisung, Google Pay, Apple Pay, Shop Pay, eps-Überweisung, Bancontact and iDeal.

How do I receive my lab report?

We will send your doctor /therapist an email with a download link to your lab report. If you sent the test directly to us, you will receive the report via a download link.

When will my doctor /therapist receive my results, or when will I receive them?

Approximately 2–3 business days after receipt of the test. (During COVID-19: approximately 4–5 days after receipt of the test.)

I've received my lab report. What happens next?

Always discuss your results with your doctor and/or therapist. SIBO can and should be treated. We are gathering scientific information to provide you with options for action and everyday tips. If the result is negative, continue searching for the cause – ideally together with your doctor/therapist.

Can I make the test available to my patients?

Yes. The test is designed as a home test, allowing your patients to perform the test regardless of your practice's time constraints. Simply refer to our website or email the link to our product page to your patients: https://www.sibolab/products/atemtest .

Alternatively, we can send you order forms that you can complete and sign with the patient and fax to us. Please feel free to contact us if you prefer this method.

Can you send us information about the breathalyzer test?

Yes, of course. Please email us at info@sibolab.de or call us at +49 (0) 30 49 500 833.

Where can I get further training on SIBO?

On Doctaris, the information platform for functional-integrative, preventive & holistic medicine, you will find an online course on basic knowledge and a variety of documents and studies that can support you in your work at https://doctaris.com/fachkreise-partner/sibolab/ .

You must register with Doctaris to use this, but basic access is free.

Can I also purchase the test directly?

Yes. However, Sibolab is expressly not a substitute for consultation with a doctor or therapist. The test results should always be interpreted by a doctor or therapist.

What is SIBO?

SIBO refers to bacterial overgrowth of the small intestine and is the most common cause of irritable bowel syndrome (IBS). SIBO is an abbreviation for small intestinal bacterial overgrowth .

What symptoms occur with SIBO?

Common symptoms of SIBO include:

• bloated stomach
• Abdominal pain and/or cramps
• Altered stool frequency and/or consistency (constipation, diarrhea, or both)
• flatulence
• nausea
• fatigue
• Belching
• heartburn

What are the signs of SIBO?

• First symptoms appear after treatment with antibiotics, painkillers or other medications
• Fiber worsens symptoms
• Despite a gluten-free diet for gluten intolerance, the symptoms remain
• Probiotics do not help or worsen symptoms
• Antibiotics seem to improve symptoms (temporarily)
• Difficulty concentrating and dizziness
• Unexplained weight loss
• Blood tests show chronic iron or B12 deficiency with no known cause

What happens in the body with SIBO?

In a healthy digestive tract, the small intestine is barely colonized with bacteria. The large intestine, which follows the small intestine, is colonized with many different bacteria. These bacteria are beneficial and beneficial in the large intestine, but harmful in the small intestine. In SIBO, there are significantly too many bacteria in the small intestine. In addition to a disrupted closure between the small and large intestines (ileocecal valve) and insufficient movement of the gastrointestinal muscles, there are many different causes. As a result of this overgrowth, a range of symptoms can occur that are comparable to irritable bowel syndrome (IBS).

Is SIBO treatable?

Yes, SIBO is generally treatable. Please consult a doctor or therapist who is familiar with SIBO.