Everything you need to know to start treating SIBODr. Alison Vandekerkhove BSc, ND
SIBO Canada
▪ I started with the treatment of SIBO for IBS type symptoms
▪ My practice has a large focus on women’s health and hormones
▪ Patients that would not get better with treatment- particularly patients who are SENSITIVE to treatments
▪ Started testing and treating for SIBO▪ Great results- got passionate in the treatment of
SIBO- started SIBO Canada
Why I became interested in SIBO
SIBO Canada: What I wanted to do for my profession
I wasn’t getting what I needed from the other local labs and USA labs so pricey.
I have a Quintron machine and kits in my office that I use for my patients.
My fellow Doctors that were friends were asking if they could do testing for their patients
I wanted to start a small company that could do the following:
▪ Have more clinics able to do SIBO- all Naturopaths should be treating for it.
▪ Make it easy for the patient
▪ Make it easy for the doctors
▪ Make that the doctors could make some money
▪ Not make a clinic affiliated with the lab for the patient
WHAT IS SIBO
What is SIBO
▪ SIBO Stands for Small Intestinal Bacterial Overgrowth
▪ SIBO occurs when bacteria ( that is normally present in the large intestine ends up in the small intestine)
▪ These are not pathogenic bacteria- just bacteria in the wrong place
▪ These bacteria interfere with the digestive processes leading to the many symptoms of SIBO
▪ HCl in the stomach and the ileocecal valve below the small intestine should keep these bacteria in check
▪ It is estimated that about 70-80% of IBS sufferes have SIBO
IBS after the stomach flu Patients feels better on antibiotics
Absortion issues ( ie: always low ferritin)
Never well since surgery
Sensitive to everything
Fibre or probiotics makes them feel unwell or very bloated
1. 2. 3.
4. 5. 6.
Key symptoms that I look for:
01
02
03
04
05
06
07
08
09
10
Gas
Bloating
Constipation
Diarrhea
Anemias
Weight loss
Fatigue
General feeling of being unwell
Anxiety and depression
Weight gain in the abdomen
Sensitivities to foods and medicine
11
12
Brain fog
Symptoms of SIBO
Associated Conditions
Acne ( vulgaris and Roscea)
Anemia
Autoimmune conditions
Gastritive
Autism
Cancer
Celiac Disease
Cystic Fibrosis
Medications ( PPi, Opiates, NSAIDS)
IBD
IBS
Interstitial Cystitis
Leaky Gut
Lymes
CFS
Obesity
Pancreatitis
Parasites
Diverticulitis
Fatty Liver
Fibromyalgia
Gallstones
GERD
Hepatic Issues
H-pylori
Hypochlorhydria
Hypothyroidism
Parkinsons’s
Malabsortion
Diabetes
syndrome
Prostatitis
Restless legs syndrome
Surgery
SIBO Diagnosis
Test Endoscopy Breath Test Stool Analysis Organic Acids
Procedure Invasive Non-invasive Non-invasive Non-invasive
Cost $$$$ $$ $$ $$$
Measurement Direct Indirect Direct Indirect
Culture Able to culture only Aerobic bacteria
Unable to culture Unable to culture Unable to culture
Location of bacteria
Only the proximal part of the small intestine
The whole intestine with the 10 breath sample
The distal part of the colon only
Does not distinguish location of bacterial growth
▪ Test for Hydrogen and Methane gases in the intestine
▪ Can use lactulose or glucose for the test
▪ Recommended to use lactulose due to:
1 2
3
Not absorbed by humans so it is still in the distal part of the intestine
Glucose is absorbed so may only detect bacteria in the proximal part of the small intestine.
Not a Rx in Canada so readily available
Quintron Breath Test
Quintron breath Test Continued
▪ This is a 3 hour breath test that is done in the A.M after 24-48 hours of preparation
▪Breath samples are done every 20 minutes till the 10 tubes are completed.
▪Prep Diet: for the test- recommended to do for 24 hours(severe constipation do for 48 hours)
▪Can consume: animal proteins, hard cheeses, eggs, white rice, oil, salt and pepper, black coffee
▪ Fast required for 12 hours before the test
antibioticsAll
enzymes
antacidslaxative
s
PPI’sprobiotics
1 week prior to test
Breath test instructions
Best is to show your patients a u-tube video.
Here is an example of one:
https://www.youtube.com/watch?v=GICPncxiyhY
Some examples of the Breath test Report
It is very important when you get a test back that you look at the patients clinical picture when reviewing the test
Some key points to keep in mind
▪ Most of the time over 120 minutes is considered to be in the large intestine
▪ A test where the baseline is high can mean a few things: they did not do the prep correct, the bacteria are in the
stomach, in the case of methane- high baseline is a positive
▪ If the patient blows too hard the CO2 will increase and the numbers will be out( the chart will show a zero)
▪ Sometimes a methane producer of a 3 will be considered positive
▪ Methane bacteria eat hydrogen bacteria- might show hydrogen negative till the methane bacteria have been
irradicated
SOURCE OF SPECIMEN:10 timed breath samples
SUBSTRATE USED: Lactulose CLINICAL HISTORY: Not Indicated
CLINICAL IMPRESSIONS:Rule out small intestinal bacterial overgrowth
Summary Report Of Hydrogen & Methane Breath Analysis with Carbon Dioxide
Correction
Sample Norm-illutio
n*
Gasses Analyzed:
Patient Result (ppm)
Expected (Small Intestine only)
Number
Collection Interval
ppm H
2
ppm CH
4Combined
ppm CO
2f CO
2
1 Baseline 3 0 3 4.7 1.06
Increase in Hydrogen (H
2) Level:
26 HI
(ppm
)
SIBO example #2
SIBO example
Breath analysis standards for abnormal tests are suggested if an increase of 20 ppm for Hydrogen (H2) or 12 ppm for Methane (CH
4), or a combined 15
ppm for Hydrogen (H2) & Methane (CH
4) is detected.
Only the treating clinician is able to determine if there are additional factors that colud have a material impact on the results of this analysis.
A diagnosis can only be obtained from a medical professional that combines clinical information with the results of this breath analysis.
The results of this Hydrogen (H2) & Methane (CH
4) breath test should be utilized as a guideline only.
Sibo Canada does not have access to patient clinical information that is critical for diagnosis determination.
Quality Control:
Sibo Canada performs quality control analysis on specimens processed using rigorous standard operating procedures, established Quintron
Hydrogen (H2) & Methane (CH
4) breath test values are corrected by Sibo Canada state-of-the-art solid state sensor technology & scientific algorithm for
Carbon Dioxide (CO2) content in the sample.
* The correction factor, f(CO2) is used to determine if each sample is valid for analysis. A f(CO2) close to 1.00 is indicative of a good alveolar sample, while
a factor in excess of 4.00 is indicative of a poor sample.
** 3 ppm of CH4 with reportof small intestinal bacterial overgrowth.
Important Information - Please Read:
Summary Report Of Hydrogen & Methane Breath Analysis with Carbon Dioxide Correction Sample Norm-illution*
Gasses Analyzed: Patient Result (ppm) Expected (Small Intestine only)Number Collection Interval ppm H
2ppm CH
4Combined ppm CO
2f CO
2
1 Baseline 4 28 32 3.4 1.47
Increase in Hydrogen (H2) Level: 50 HI
SIBO test #5- Methane positive(ppm
)
Hydrogen & Methane Breath Results
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