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Kirsten Jackson Consultant BSc Hons PG Cert RD

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Hydrogen Breath Testing

by Kirsten Jackson Consultant Dietitian BSc Hons, RD, PG Cert 2 Comments

Hydrogen breath testing used to be used routinely to diagnose food intolerances and is still currently used to diagnose SIBO. It is not painful and runs very few risks to an individual’s health.

In this article I will explain why I wouldn’t recommend a hydrogen breath test for food intolerance diagnosis anymore. I will also go through the role within SIBO diagnosis.

What Is A Hydrogen Breath Test Used For?

A hydrogen breath test is used to test for lactose intolerance, fructose intolerance and small bowel bacterial overgrowth (SIBO).

The test works by detecting carbohydrate malabsorption e.g. sugars such as lactose and fructose or it can be the result of an overgrowth of bad bacteria e.g. SIBO.

How Does The Hydrogen Breath Test Work?

  • Lactose Intolerance Testing

You will be asked to take a  water based drink containing around 25-50g of lactose. After this, breath tests will be taken every 15 – 30 minutes for the next few hours (1, 2).

Normally, lactose is broken down in your small intestine to form glucose and galactase. This process is done by an enzyme called lactase (3).

If you do not break down the lactose properly in your small bowel, it reaches the large bowel and is broken down by bacteria producing hydrogen (3).

Levels of hydrogen found in your breath which are significantly higher than your usual levels are said to indicate an intolerance (1).

The tester will also make note of any digestive symptoms such as diarrhoea and stomach cramps. If these symptoms do not occur, your results may be the result of something else (3).

  • Fructose Intolerance Testing

You will be given a water based drink containing 25 – 50g of fructose. Again, hydrogen measurements will be taken from your breath every 30 minutes for 4-5 hours (1).

Fructose is usually absorbed in the small bowel and does not need any enzymes to help it (4).

In fructose malabsorption, the fructose does not get absorbed in the small bowel and instead travels to the large bowel taking lots of water with it. In the large bowel it meets lots of gut bacteria and again hydrogen (amongst other gases) is produced (4).

Unlike testing for lactose, fructose testing is not as accurate or as useful. This is due to the lack of good quality studies providing an ‘optimal’ fructose dose for testing (1).

Not only this, but most foods that contain fructose, also contain glucose. Glucose helps to absorb fructose and so if you test positive, it may be that you can actually tolerate a good bit of fructose, despite being ‘intolerant.’

  • Short Intestinal Bacterial Overgrowth Testing (SIBO)

To test for SIBO, a water based drink containing either glucose or lactulose is provided. Breath tests are then taken every 15 minutes for up to 3 hours (1. Both hydrogen and methane measurements are taken during this  test (5).

Lactulose can not be broken down by the human gut and is usually used as a laxative. When it is taken during this test and a rise in hydrogen or methane is shown, this indicates that there is bacteria in the small bowel breaking it down.

Glucose can be broken down by either bacteria or absorbed in the small bowel. When bacteria breaks down glucose, it gives off hydrogen. Therefore, any increase in hydrogen shows that there is unusual amounts of bacteria (SIBO) in the small bowel. Glucose is absorbed at the start of the small bowel and so is a good test substance to use as it doesn’t involve mechanisms further down the gut (1).

How To Get A Hydrogen Breath Test

Due to new research suggesting that hydrogen breath testing is not accurate for food intolerance diagnosis it is no longer used in most practises.

For SIBO testing, this will need to be carried out by a gastroenterologist or can be organised in a private clinic.

Please note that if you opt to go privately that you should be prepared to pay not only for the test but subsequent gastroenterology appointment and antibiotics if this is not covered by private health insurance.

Accurate Food Intolerance Diagnosis

There is currently no test out there which will accurately diagnose a food intolerance. Instead, you will need to carry out an elimination diet with a registered dietitian.

Symptoms which go away when a food is eliminated and then come back when the food is reintroduced will form a diagnosis.

Bottom Line

Hydrogen breath testing is only partly accurate for SIBO diagnosis and even this is controversial. Some gastroenterologist do not use this test and will go off symptom history alone.

Hydrogen breath testing is not an accurate way to diagnose food intolerances and can lead to false results. Instead, you will need to undergo an elimination style diet such as the low FODMAP diet with a dietitian to pin-point your sensitivities.

To book in for help with a food intolerance, contact me today.

Kirsten Jackson Consultant Dietitian BSc Hons, RD, PG Cert

Kirsten Jackson is a UK registered Consultant Gastroenterology Dietitian and founder of The Food Treatment Clinic. She has undergone many qualifications to get where she is today, including a UK BSc Honours Degree in Dietetics and Post-Graduate Certificate in Advanced Dietetics. In addition to this, she has FODMAP Training from Kings College London University. Kirsten set up The Food Treatment Clinic in 2015 after first experiencing digestive problems herself. She felt that the NHS was unable to provide the support individuals needed and went on to specialise in this area before opening a bespoke IBS service. Kirsten also participates in charity work as an Expert Advisor for the IBS Network. In addition, she can be seen in publications such as Cosmopolitan and The Telegraph discussing IBS as an Official Media Spokesperson to the IBS Network.

Filed Under: Treatments, Testing and Diagnosis Tagged With: IBS testing

About Kirsten Jackson Consultant Dietitian BSc Hons, RD, PG Cert

Kirsten Jackson is a UK registered Consultant Gastroenterology Dietitian and founder of The Food Treatment Clinic. She has undergone many qualifications to get where she is today, including a UK BSc Honours Degree in Dietetics and Post-Graduate Certificate in Advanced Dietetics. In addition to this, she has FODMAP Training from Kings College London University. Kirsten set up The Food Treatment Clinic in 2015 after first experiencing digestive problems herself. She felt that the NHS was unable to provide the support individuals needed and went on to specialise in this area before opening a bespoke IBS service. Kirsten also participates in charity work as an Expert Advisor for the IBS Network. In addition, she can be seen in publications such as Cosmopolitan and The Telegraph discussing IBS as an Official Media Spokesperson to the IBS Network.

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Reader Interactions

Comments

  1. Shirley ann Dixon says

    at

    Hello

    Ive been referred to you from Coeliac UK. I have CD which is not responding to diet and now, having had a breath test, I also have an overgrowth of bacteria. I have tried to open the contact form but cannot. Can you email it to me please? S

    Thank you

    Shirley

    Reply
    • Kirsten Jackson Specialist Dietitian says

      at

      Hi Shirley! How strange – I will check out what is going on. Can you email my PA? Admin@thefoodtreatmentclinic.com -she will get you booked in with one of my specialists for a complimentary video call. It sounds like you have a SIBO +/- IBS which is common in coeliac.

      Reply

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WHAT ELSE WOULD YOU ADD? COMMENT BELOW πŸ‘‡ ​​ WHAT ELSE WOULD YOU ADD? COMMENT BELOW πŸ‘‡ ​​​​​​​​
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πŸ’©πŸ’© Do you wish you could manage constipation πŸ’©πŸ’© Do you wish you could manage constipation naturally?

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4️⃣ Avoidance of fatty foods - fatty foods can trigger your gastro-colic reflex
5️⃣ Avoid large portions - again this can trigger the gastro-colic reflex
6️⃣ Meditation - stress can cause loose stools through the gut-brain axis

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What else could you add to this travelling list? C What else could you add to this travelling list? COMMENT BELOW πŸ‘‡ ​​​​​​​​
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Can you relate? Comment below πŸ‘‡ ​​​​​ Can you relate? Comment below πŸ‘‡ ​​​​​​​​
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☺️ The Take Controls multi-factorial approach considers the emotional symptoms of IBS as well as the physical. This is turn has helped so many of my members to achieve that ultimate symptom relief.​​​​​​​​
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WHAT WOULD YOU ADD? Comment below πŸ‘‡ ​​​​​​​​
​​​​​​​​
😣 IBS is a condition that others cannot see. As humans, we struggle to understand or truly believe in things that we can't touch, hold or see. As a result, IBS sufferers often feel quite alone.⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​
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πŸ€”When you were diagnosed with IBS did you get a πŸ€”When you were diagnosed with IBS did you get a prescription of Buscopan and left to fend for yourself?

⏩ Let's be clear πŸ™ for some people, this works so great - carry on. But the chances are, that it isn't.

⏩ ⏩ If this isn't working for you, know this.. taking medications like this for IBS can be like taking a painkiller for a headache, they don't really resolve the underlying situation.

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CAN YOU ADD ANYTHING ELSE? Comment below πŸ‘‡ ​​​​​​​​
​​​​​​​​
πŸ€·β€β™€οΈIBS is such a frustrating condition it can take a lot to mentally process. Why you? What did you do to deserve to get a condition that no one understands, that impacts your whole life and for which there is no cure?⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​
⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​
πŸ™‹β€β™€οΈ I often hear awful client stories about how when they finally pluck up the courage to reach out for help they are dismissed. This could be opening up to a friend about trialling the low FODMAP diet or perhaps seeking medical help from a doctor. Again frustration, anger and hurt can build. ⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​
⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​
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πŸŽ‰ Take Control 2.0 success πŸŽ‰ πŸ™ Thank you πŸŽ‰ Take Control 2.0 success πŸŽ‰

πŸ™ Thank you to Mike for agreeing to chat about his experiences and how his health has been impacted.

⏩ As always, please note that this is a personal story and can not act as a guarantee of outcomes.
Can you relate? Comment below πŸ‘‡πŸ˜’β€‹β€‹β€‹β€‹ Can you relate? Comment below πŸ‘‡πŸ˜’β€‹β€‹β€‹β€‹β€‹β€‹β€‹β€‹
​​​​​​​​
πŸ˜” IBS is totally exhausting with experiencing the symptoms and the emotions that come alongside that but also with trying to find something that works to get  that all important symptom relief. You end up feeling totally defeated that you've tried every diet or remedy out there and still coming back with the same symptoms.…​​​​​​​​
​​​​​​​​
😊️ Instead of continuously dealing with the above​​​​​​​​
emotions, adopt a small change like the Take​​​​​​​​
Control method of tracking your sleep, mood, food intake and symptoms. This will allow you to start to gain control as you start to see patterns/ triggers to what is causing your symptoms.​​​​​​​​
​​​​​​​​
πŸ₯³πŸ₯³ Fed up of trying everything you can but nothing​​​​​​​​
seems to be working? Download my FREE top 10 IBS​​​​​​​​
mistakes! Link in bio.​​​​​​​​
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SHOCKED BY ANY OF THESE FACTS? ​​​​​​​​
Comment below πŸ‘‡ ​​​​​​​​
​​​​​​​​
😫 There is a lot to know about IBS and it is easy for​​​​​​​​
people to become confused and overwhelmed😫.​​​​​​​​
​​​​​​​​
😊 Want to increase your knowledge on IBS and make​​​​​​​​
IBS work around your life, not work your life around​​​​​​​​
your IBS? Work with me and adopt the Take Control Method to help achieve that all important symptom relief.​​​​​​​​
​​​​​​​​
πŸŽ‰ Fed up of trying everything you can but nothing seems to be working? Download my FREE top 10 IBS mistakes! Link in bio.⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​​​​​​​​
​​​​​​​​
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#5steps #chronichealth #multifactorial.​​​​​​​​
#chronicallyunwell #endo #ibstype #ibstyping #ibsc
πŸ’© Have you experienced this before? Comment bel πŸ’© Have you experienced this before? Comment below πŸ‘‡

⏩ IBS is partly diagnosed through the exclusion of other conditions so your test results should come back negative.

⏩ BUT this doesn't meant there is nothing wrong with you.

πŸ™ Don't ever let anyone make you believe that your IBS is all in your head.

#irritablebowelsyndrome #ibs #dietitian #chronichealth
Can you add any more? Comment below!πŸ‘‡πŸ‘‡β€‹β€‹ Can you add any more? Comment below!πŸ‘‡πŸ‘‡β€‹β€‹β€‹β€‹β€‹β€‹β€‹β€‹
​​​​​​​​
πŸ˜₯ IBS has widespread implications on our overall health and well-being and it can feel like a never ending battle.​​​​​​​​
⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​
😊 Our gut health plays a big role in our overall health and wellbeing! Therefore it is super important we adopt the Take Control Method and focus on all aspects of well-being not just nutrition! ​​​​​​​​Sleep, movement and mental health optimisation are just as important!​​​​​​​​
​​​​​​​​
πŸŽ‰ Fed up of trying everything you can but nothing seems to be working? Download my FREE top 10 IBS mistakes! Link in bio.⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​
#ibsdiet diet #ibs #guthealth #ibsfood #guthealth #lowfodmapdiet #guthealthy #guthealing #guthealthdiet #guthealthiskey #bloating #gutmicrobes #gutscience #healthylife #bloating #irritablebowelsyndrome #fodmapfree  #healthygut #goodguthealth #gutfood #fermentedfoods #trustyourgut #chronichealth #microbiome #tipsforgoodguthealth #guthealth #guthealthtips
CAN YOU RELATE? COMMENT BELOW ⬇️⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​
πŸ‘‰Anyone else feel like they just can't catch a break from IBS for just one minute? I've said it before and I will say it again, IBS is a debilitating condition that can impact so many aspects of your life, the big and the small things - they can all be a struggle when you have IBS!β €β €β €β €β €β €β €β €β €β €β €β €β €β €β €β €β €β €β €β €β €β €β €β €β €β €β €β €β €β €β €β €β €β €β €β €β €πŸ‘ But what if you could fully understand your IBS so you were able to identify your triggers AND improve gut health so it was less sensitive - this would allow you to control your IBS, and enjoy life! Seek help from a trained professional βœ”οΈ.​​​​​​​​
​​​​​​​​
πŸŽ‰ Fed up of trying everything you can but nothing seems to be working? Download my FREE top 10 IBS mistakes! Link in bio.β €β €β €β €β €β €β €β € ⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​
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What else do people not understand when they hear What else do people not understand when they hear IBS? Comment below ⬇️ ​​​​​​​​​​​​​​​​
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☹️On the surface, IBS is seen as no more than a pathetic excuse to complain. But dig just a little bit deeper and you will find that IBS is so much more than what it seems and far worse than others can ever imagine πŸ˜”.​​​​​​​​​​​​​​​​
​​​​​​​​​​​​​​​​
πŸ€” Sometimes having someone that understands is the most important thing…so that you don’t feel β€˜guilty’ for being ill. In the Take Control Method, emotional support is seen as the foundation for IBS control - it is so important to have a hand to hold when you need it!​​​​​​​​​​​​​​​​
​​​​​​​​​​​​​​​​
πŸ₯³ πŸŽ‰ Fed up of trying everything you can but nothing seems to be working? Download my FREE top 10 IBS mistakes! Link in bio.​​​​​​​​​​​​​​​​​​​​​​​​
​​​​​​​​​​​​​​​​
#ibs #irritablebowelsyndrome #bloating #diarrhoea #constipation #bloatingtips #ibsdietitian #ibsdiet #ibstips
πŸ’© Is this you? Comment below πŸ‘‡ ⏩ Did you πŸ’© Is this you? Comment below πŸ‘‡

⏩ Did you know the low FODMAP diet is only part 1 of 3 of the process? After 4-6 weeks you are supposed to followed a structured reintroduction to diagnose your food intolerances.

⏩ Did you know that FODMAPs are good for your microbiome and continuing to restrict them without need with reduce your levels of good gut bacteria. The diet can also increase your risk of nutritional deficiencies.

⏩ Don't forget to download my free IBS guide - link in bio

#irritablebowelsyndrome #lowfodmapdiet
#fodmapfree #dietitian
Do you practice any of these to help​​​​​​​​
with IBS management? Comment below πŸ‘‡ ​​​​​​​​
 ​​​​​​​​
😒 IBS is a very complex disorder to navigate by​​​​​​​​
yourself. It's way more than just changing your diet,​​​​​​​​
contrary to what people think, a lot of factors are at​​​​​​​​
play with your IBS.​​​​​​​​
​​​​​​​​
πŸ™Œ Adopting the Take Control Method, where the 4​​​​​​​​
pillars of IBS relief are all addressed (diet, movement,​​​​​​​​
mental-health and sleep), has helped so many of my​​​​​​​​
members to achieve that ultimate symptom relief. The​​​​​​​​
Take Controls multi-factorial approach considers​​​​​​​​
EVERYTHING not just what goes into your mouth!​​​​​​​​
Why don't you try to incorporate one of these factors​​​​​​​​
this week, just 5 minutes of meditation or ensuring​​​​​​​​
adequate hydration!​​​​​​​​
​​​​​​​​
πŸŽ‰πŸŽ‰ Fed up of trying everything you can but nothing​​​​​​​​
seems to be working? Download my FREE top 10 IBS​​​​​​​​
mistakes! Link in bio.​​​​​​​​
​​​​​​​​
#ibsdiet #ibsmanagement #guthealth #ibsfood​​​​​​​​
#guthealth #lowfodmapdiet #guthealthy #guthealing​​​​​​​​
#guthealthdiet #guthealthiskey #bloating​​​​​​​​
#gutmicrobes #gutscience #healthylife​​​​​​​​
#lowfodmapdiet #bloating #irritablebowelsyndrome​​​​​​​​
#fodmapfree #gutinstinct #healthygut #ibsd​​​​​​​​
#ibsmanagement #ibssymptomrelief #IBShelp
Do you suffer from bloating? Comment below πŸ‘‡ ​​​​​​​​
​​​​​​​​
🀰 Bloating is a common symptom for those suffering from IBS or digestive issues. Bloating often results in significant pain/ discomfort and I have seen it time and time again in my clinic where my clients don't want to leave the house for fear of bloating. It really can ruin your whole day and just make you feel downright​​​​​​​​
rubbish!​​​​​​​​
​​​​​​​​
Life should not and does not have to be like this! 🀰 By investing in a qualified professional such as an IBS dietitian you can take control of your life and live bloat free! πŸ‘  The Take Control Method can help with foods and drinks you may better tolerate. ​​​​​​​​
​​​​​​​​
πŸŽ‰ Fed up of trying everything you can but nothing​​​​​​​​
seems to be working? Download my FREE top 10 IBS​​​​​​​​
mistakes! Link in bio.​​​​​​​​
​​​​​​​​
#ibsbloattips #ibsbloat #ibs #ibsdiet #ibsmanagement #guthealth #ibsfood #guthealth #lowfodmapdiet #guthealthy #guthealing #guthealthdiet #guthealthiskey #bloating #gutmicrobes #gutscience #healthylife #lowfodmapdiet #bloating #irritablebowelsyndrome #fodmapfree #gutinstinct #healthygut #ibsd #ibsmanagement #ibssymptomrelief #IBShelp
πŸŽ‰ We hit 40k team! πŸŽ‰ πŸ™πŸ™ A huge thank πŸŽ‰ We hit 40k team! πŸŽ‰

πŸ™πŸ™ A huge thank you to all of you for getting behind this account! It means the world to me and my team.

πŸ™πŸ™ How many followers we have is not a simple vanity metric. The more followers = the more people who are getting researched backed health advice for what is otherwise a debilitating condition.

⏩ ⏩ As a little thank you πŸ™ I am going to be giving 1 person access to my Take Control 2.0 Programme.

⏩⏩ To enter - simply tag a friend or family member below. I will privately message the winner in 1 weeks time.
⏩ Can anyone relate? Comment below πŸ‘‡ πŸ’© IB ⏩ Can anyone relate? Comment below πŸ‘‡

πŸ’© IBS impacts all areas of your physical and mental health which can lead you to feeling pretty isolated.

πŸ™ Please know this - there may be no 'cure' for IBS but you can manage it effectively. You don't need to accept your symptoms.

We have some things that may help;
1️⃣ Join our free FB group where you can find others like you - search 'IBS Management for Women' in your FB search bar.
2️⃣ Download my free guide (link in bio) which covers the top 10 mistakes I see people making with their IBS.

#dietitian #gutbrainaxis #mentalhealth #irritablebowelsyndrome
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