If you suffer from difficult abdominal symptoms like pain and bloating, along with excessive wind with an eggy sulphur smell, hydrogen sulphide may be your problem. Hydrogen sulphide (H2S) is gas made by some species of bacteria in your gut, and if there is too much, this can cause a problem! At FGC, we have just launched a new breath test that can measure H2S, so we can see if this gas is the culprit for your troublesome symptoms.
The breath test can be performed at one of our clinics in London, Cambridge, or Manchester. Our test involves blowing into a bag to collect breath samples at different time points over 3 hours after drinking a sugar substrate. This allows us to measure how much hydrogen sulphide is produced by your gut bacteria, so we can identify any overgrowth.
What can I do if the test comes back positive?
As the hydrogen sulphide test is still very new, there isn’t much research into the best treatment strategy. However, we’ve put together a few different options that have been shown in research to be helpful. For some of these you would need a doctor’s prescription, but some you can try yourself.
Low sulphur diet
Certain types of gut bacteria use sulphur from foods you eat to produce hydrogen sulphide, so a diet low in sulphur can reduce this excessive gas. Foods such as cruciferous vegetables (think broccoli, cauliflower, kale and sprouts), red meat, eggs, dried fruits, beer, and wine, are all high in sulphur, so reducing intake of these foods can help to reduce levels of hydrogen sulphide. You can try a low-sulphur diet for a week or so to see if it reduces your symptoms, but we would always advise to consult with a dietician before making any drastic long-term changes to your diet.
Another option is bismuth subsalicylate, which has been shown to dramatically reduces levels of hydrogen sulphide in the gut. You can take bismuth in tablet form, or you may have heard of it in liquid form – Pepto-Bismol!
Green tea is often labelled as a “superfood”, and it can even be helpful for hydrogen sulphide SIBO! Research has shown green tea extract to reduce levels of hydrogen sulphide, so can help to reduce gassiness that causes SIBO symptoms.
For hydrogen or methane dominant SIBO, treatment with antibiotics such as rifaximin is often the best course of action! Rifaximin targets gut bacteria that produce excess gas, and has shown to have really good results in reducing symptoms in SIBO patients. Although it hasn’t been researched for hydrogen sulphide SIBO specifically, it would target the bacterial overgrowth responsible for symptoms in the same way, and so would likely have the same benefits.
Wang, J., Zhang, L. and Hou, X. (2021) ‘Efficacy of rifaximin in treating with small intestine bacterial overgrowth: a systematic review and meta-analysis’, Expert review of gastroenterology & hepatology.
Suarez, F.L. et al. (1998) ‘Bismuth subsalicylate markedly decreases hydrogen sulfide release in the human colon’, Gastroenterology Zeng, Q.C., Wu, A.Z. and Pika, J. (2010) ‘The effect of green tea extract on the removal of sulfur-containing oral malodor volatiles in vitro and its potential application in chewing gum’, Journal of breath research.