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Questions?

Neurovanna is owned and operated by Drs. Rebecca and Bradley Bush. Their Brain-Gut approach to health is a corner stone to their medical practices and the reason behind their passion to assess and address SIBO. 

651-342-0427

Lab

847-508-1692

Sales Support

Testing Instructions

Breath Testing

The Hydrogen/Methane Breath Test with lactulose challenge is used to diagnose SIBO. This test can be performed in at a hospital or clinic lab, but take home collection kits have become available and more commonly used. The test is performed after the cessation of certain medications that interfere with your regular intestinal motility, digestion, and microflora balance. A 1-2 day preparation diet is also required. We will outline SIBO collection instructions below and have included a video that should be watched before performing a SIBO test. 

Neurovanna How to Collect Breath Testing Instruction Video
Neurovanna How to Collect Breath Test

Neurovanna How to Collect Breath Test Instructional Video.

The number of people with IBS with SIBO

50-80%

SIBO Testing

 

Non-Invasive home collection. ​

Breath Testing Guidelines

The Process

  1. You purchased your Lactulose Breath Test.

  2. Neurovanna makes available convenient breath collection videos on our website under the “Testing Instructions” tab (https://www.neurovanna.com/testing-instructions) that will allow you to view the collection procedure. We recommend you watch the posted video twice; immediately once you get the kit and again just before performing the testing.

  3. 1-2 day prep diet (diet outlined below).

  4. Don’t forget to watch collection video a second time.

  5. Perform test (see instructions below).

  6. You will return your breath specimens by placing them in the same box it arrived in and mailing back (USPS) to Neurovanna. Please complete and include the enclosed Patient Intake Form in the return box. Lab must receive your specimens within 7 days of collection. 

  7. Neurovanna will analyze your breath specimens and generate a report within 1-3 business days of receipt of your specimens.

  8. Test results will be sent to the ordering practitioner. Call your ordering practitioner if you have questions. We can also assist you with any collection questions by calling 1-651-342-0427.

Testing must be received by clinic 7 days after completing the test! It is recommended to mail out ASAP 

 

Mail Specimens (USPS postage included) to:

Neurovanna

105 New England Place, Suite 220

Stillwater, MN 55082

 

Testing for SIBO

The hydrogen/methane breath test with a glucose/lactulose challenge is used to aid in the diagnose of small intestinal bacterial overgrowth (SIBO). The test is performed after the cessation of certain medications that interfere with regular intestinal motility, digestion and microflora balance. A 1-2 day preparation diet is also required; your doctor has instructed you on the duration of the diet. 

Before Testing

If you are not able to comply with these guidelines for testing, then you may not be a candidate for a breath test and your doctor can assist you in determining if another test without these preparation limits is more suitable. 

  • No antibiotics 4 WEEKS (28 days) BEFORE TESTING. In some cases, 2-weeks away from antibiotics may be suffice; ask your prescribing practitioner if this includes to you. 

  • No antifungals 2 WEEKS (14 days) BEFORE TESTING. 

  • WAIT TWO WEEKS (14 days) after surgery, colonoscopy, enemas, or colonics.

  • 4 DAYS BEFORE YOUR TEST avoid all laxatives. This includes (high dose) vitamin C and magnesium that is being taken specifically to induce a laxative effect.

  • No smoking, including second-hand smoke, for at least 1 hour before or at any time during the breath test. 

  • No sleeping or vigorous exercise for at least 1 hour before or at any time during the breath test.

Before you start the breath test, a 1-2 day preparation is required consisting of a 1-2 day (12-36 hours) restricted diet and a 12-hour fasting period (stop eating in the early evening the day before testing and do not eat until after you test that following morning). 

If you are uncertain if something will affect the test, avoid the product/ food or consult your physician prior to starting the test.

Prep Diet

If you suffer from constipation, follow the SIBO preparation diet for 2 days (36 hours plus overnight fasting). If you suffer from diarrhea, follow the SIBO preparation diet for 1 day (12 hours).

The first 12 or 36 hours is the restricted diet.  Limit your foods to those below, and nothing else:

  • You may drink plain water, coffee, tea (no sugar/artificial sweeteners or cream added)

  • Baked or broiled chicken, fish or turkey. (Salt and pepper only) (no butter or oils)

  • Plain steamed white rice

  • Eggs

  • Meat broth (e.g. liquid used to make slow-cooker chicken breast). Regular broth that may  have been made from bones or vegetables is not allowed.

The goal of the SIBO preparation diet is to starve your bacteria in order to produce the best test results. SIBO bacteria love plant products and sugars, so the only foods that you can have are those listed above – if it is not on this list DO NOT eat it.

Fasting Before the Test

Stop eating the evening before the morning of your test; similar to a fasting blood draw.  ​The last 12 hours DO NOT eat or drink anything, except water

Neurovanna breath testing prepartation video
Neurovanna Breath Testing Prep Video

Neurovanna Breath Testing Preparation Video.

​SIBO Preparation Diet Length

Constipation = 2 days

Diarrhea = 1 day

Frequently Asked Questions
 
I have diabetes, should I test with glucose? 
Patients with Type I: Do not take the glucose test. A lactulose test requires a test order by a prescribing practitioner.
Patients with Type II: Forgo medications day of test and start the test as early as possible in the morning. Lactulose can be used, but requires a lab order by prescribing practitioner. 
 
Is glucose a better than lactulose for breath testing?

There are two common substrates used for the breath testing challenge. Glucose is the most commonly used substrate due to having 11.1% greater sensitivity than lactulose. Glucose’s improved sensitivity is contributed to its ability to be absorbed in the small but not the large intestines. Glucose’s exclusive small intestinal absorption reduces false interpretations of colonic gas produces in cases of rapid or delayed bowel transit. Lactulose has a 4% greater specificity than glucose and is absorbed in both the small and large intestines. Lactulose’s ability to be absorbed in both intestines allows for interpretation of double peaks of activity but can also lead to more false positives when double peaks are absent. Lactulose is a prescriptive item in the USA, regulated by the FDA and requires lawful prescribing by a practitioner.

 

  • Glucose: Most sensitive, slightly less specific, measures only small intestinal bacterial activity, can raise blood sugars levels and does not require a prescription.

  • Lactulose: Less sensitive, slightly more specific, measures both small and large intestinal bacterial activity, does not cause blood sugar levels to rise and requires a prescription.

What is lactulose?

Lactulose is a manmade sugar that humans cannot digest, but SIBO bacteria love; acting like fertilizer for SIBO bugs. Drinking lactulose will not cause the same “sugar-high” as sugars that humans can digest (like sucrose or fructose). Lactulose is also used as a laxative, so some people may experience effects of needing to use the restroom during the test. Sometimes people may feel an exasperation in symptoms caused by SIBO activity (like bloating, gas), but some people do not experience any at all. Lactulose is a prescriptive item and requires prescription for dispensing. Glucose does not require a prescription. 

Is Lactulose the same as Lactose?

No. Lactose is the sugar from milk, while lactulose is a completely different chemical makeup that is manmade. The lactulose that comes in the SIBO kits is a liquid solution. This solution, however, does contain 1.2 grams of lactose in it, so people who are severely lactose intolerant should ask their doctor if this test is right for them.

 

Which medications will affect the outcome of a hydrogen breath test?

PPIs (Proton Pump Inhibitors such as Prilosec, Nexium, and Prevacid)

  • If the patient has been on a PPI for a while (a few months), the patient may stay on the medication and leave a note listing the medication in his/her kit when it’s sent back.

  • If the patient takes it as needed or just started the medication, he/she should be off the medication for the preparation period and the day of the test.

H2 Blockers (such as Zantac, Pepcid, Tagamet)

  • If the patient has been on H2 blockers for a while (a few months), the patient may stay on the medication and leave a note listing the medication in his/her kit when it’s sent back.

  • If the patient takes it as needed or just started the medication, he/she should be off the medication for the preparation period and the day of the test.

Narcotics

  • Do not take these the day of the test

Laxatives (such as Metamucil, Dulcolax, Ex-Lax)

  • Stop taking one day before taking test

Antibiotics

  • Stop taking 2 weeks before taking test

Probiotics

  • Stop taking 5 days before taking test

Can I use seasonings during the restricted diet?

The only seasonings allowed are Salt and Pepper; used in moderation.

Can I chew gum during the preparation period?

No, gum is not allowed during any part of the preparation period.

I can not mail back my completed test right away, is this a problem?
No, the test must be back at the lab 7-days after collecting. It is recommended to mail out immediately, but a delay of 3-5 days is typically fine.