Rule out SIBO

[Nathalie Skogland]

Dr Woeller,

Since SIBO is so prevalent in most chronic conditions and probiotics/prebiotics may worsen symptoms in SIBO patients, what do you think of running a breath test (when people can afford it) to rule it out before we recommend probiotics?

Or to reformulate, can we recommend probiotics/prebiotics without having ruled out SIBO?

Maybe too far-fetched?!

Thank you,

Nathalie

[DrWoeller]

Nathalie,
I am a fan of testing and really encourage patients to do so. However, despite that sometimes people cannot or won’t do them. I don’t think performing a breath test on everyone is warranted before probiotics unless you have a practice that specialized in SIBO. A suspicion of SIBO based on clinical symptoms is fairly straightforward so the test would be done to confirm that suspicion. If you think about the bulk of patients you see and have experience with in the past they mostly do fine with probiotics and prebiotics. Another way to look at it is giving these items to an individual where it causes problems should be an indication to them to do a SIBO breath test.

Sincerely,
Dr. Woeller

[Maria Alba Aguado Jodar]

May be the screening markers in OAT commented in Module 6 lecture could also help to rule out SIBO.

[DrWoeller]

Maria,
I think the OAT is helpful. Whether it can completely rule out SIBO would have to be determined by doing repeated breath tests on people over time.
Dr. Woeller

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