By Sarah Bloor, Clinical GI Physiologist
Header photo by Alicia Harper via www.probioticreviewgirl.com
Small intestinal bacterial overgrowth (SIBO) describes the overgrowth of bacteria in the small bowel. Bacteria from the colon, which is healthy and plays an important role in digestion, can overgrow in the small bowel and cause symptoms. In patients with SIBO, bacterial overgrowth commonly causes an increase in hydrogen gas which can be measured over a period of time in response to the ingestion of a sugar substrate for a diagnosis. In contrast, the microorganisms that produce methane, known as methanogens, can overgrow in the small bowel or the colon so we call this Intestinal Methanogen Overgrowth (IMO).While methane is associated with constipation, hydrogen gas produced in excess with SIBO is associated with diarrhoea.
Methanogens are archaea, so a different microorganism to bacteria, therefore there are different treatment options for a methanogen overgrowth. See our other blog for potential ways to manage intestinal methanogen overgrowth.
The differences between a standard SIBO test and a Methane Breath CH4ECK™ are summarised in this handy table below.
What are differences between a SIBO test and a Methane Breath CH4ECK™?
|Methane Breath CH4ECK™||SIBO Breath Test|
|Measures intestinal methane gas only||Measures hydrogen and methane production in response to sugar substrate, to assess fermentation throughout the small bowel (SIBO) and colon|
|Associated with symptoms of bloating and constipation||Associated with abdominal symptoms and diarrhoea|
|No referral required||Referral from a clinician needed|
|Cost £74.99 for a postal test||Cost £250 for a postal test|
|12-hour overnight fast required prior to test||Preparation required includes medication cessation and 12-hour strict diet and 12-hour fast|
|Test complete in <5 minutes||Test takes 2-hours and 15 minutes, with breath samples required at 15-minute intervals|
|Analysis and results within 2 working days of samples being received by the laboratory||Analysis and results within 2 working days of samples being received by the laboratory|
|No substrate needed||Ingestion of 75g glucose substrate or 10g lactulose substrate required|
|Designed to be performed easily in the patient’s own home with no clinical instruction needed||Designed to be performed easily in the patient’s own home with no clinical instruction needed|
Methane Breath CH4ECK™ can help to diagnose intestinal methanogen overgrowth quickly and accurately without the need for complicated preparations and a time consuming investigation. Order your Methane Breath CH4ECK™ kit now, or if you are a practitioner interested in kits for your clients then please contact us on 0161 302 7777 or email firstname.lastname@example.org
- Kunkel D, Basseri RJ, Makhani MD, Chong K, Chang C, Pimentel M. Methane on breath testing is associated with constipation: a systematic review and meta-analysis. Digestive Diseases and Sciences. 2011; 56: 1612-1618.
- Chatterjee S, Park S, Low K, Kong Y, Pimentel M. The degree of breath methane production in IBS correlates with the severity of constipation. The American journal of gastroenterology. 2007;102:837-841
- Gottlieb K, Le C, Wacher V, Sliman J, Cruz C, Porter T, Carter S: Selection of a cut-off for high- and low-methane producers using a spot-methane breath test: results from a large North American dataset of hydrogen, methane and carbon dioxide measurements in breath. Gastroenterol Rep (Oxf). 2017, 5:193-199. 10.1093/gastro/gow048
- Rezaie A, Chang B, Chua KS, Lin E, Pimentel M: Accurate identification of excessive methane gas producers by a single fasting measurement of exhaled methane: a large-scale database analysis. Am J Gastroenterol. 2015, 110:759-760.
- Pimentel M, Saad R, Long M, Rao. ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth, The American Journal of Gastroenterology. 2020, Volume 115 – Issue 2 – p 165-178