{"id":10224,"date":"2020-04-02T10:00:31","date_gmt":"2020-04-02T14:00:31","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=10224"},"modified":"2022-06-14T11:56:38","modified_gmt":"2022-06-14T15:56:38","slug":"hydrogen-breath-test","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/hydrogen-breath-test\/","title":{"rendered":"Everything you need to know about hydrogen breath tests"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Nausea, heartburn, indigestion, upset stomach, diarrhea\u2014this group of gastrointestinal symptoms can cause a lot of distress. And, they\u2019re often mysterious. It can be hard to pinpoint exactly what\u2019s causing all that tummy trouble.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Enter the hydrogen breath test. This simple, non-invasive assessment measures gas levels in your breath to determine exactly why you\u2019re feeling those stomach complications, whether it\u2019s from bacterial overgrowth or just plain indigestion.\u00a0<\/span><\/p>\n<h2><b>How does a hydrogen breath test work?<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Taking a hydrogen breath test is a pretty straightforward process, but it requires preparation. You\u2019ll have a special diet before the test, spend about two hours in the doctor\u2019s office on the day of the test, and then wait about two weeks for your results.<\/span><\/p>\n<h3><b>Preparing for the test<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Depending on your doctor, preparation can begin anywhere from <\/span><a href=\"https:\/\/www.youtube.com\/watch?v=ghATYSHBSA0\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">four weeks<\/span><\/a><span style=\"font-weight: 400;\"> to a day before the exam.\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><b>A month<\/b> <b>before<\/b><span style=\"font-weight: 400;\">, stop taking antibiotics and avoid having a colonoscopy.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Two weeks before<\/b><span style=\"font-weight: 400;\">, stop taking probiotics.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>One week before<\/b><span style=\"font-weight: 400;\">, cut off laxative usage, smoking, and exercise.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Two days before<\/b><span style=\"font-weight: 400;\">, stop taking any prokinetics.\u00a0<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Prokinetics are medicines that are generally taken for acid reflux (think <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/reglan\"><span style=\"font-weight: 400;\">Reglan<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/pepcid-complete\"><span style=\"font-weight: 400;\">Pepcid<\/span><\/a><span style=\"font-weight: 400;\">, and <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/nexium\"><span style=\"font-weight: 400;\">Nexium<\/span><\/a><span style=\"font-weight: 400;\">) that work by increasing motility. That means they speed up the time it takes for the contents of your stomach to empty, thereby eliminating whatever might cause the acid reflux\u2014but also eliminating the bacteria the hydrogen test is trying to identify. \u201cWe want to know if the patient is having bacterial overgrowth,\u201d says<\/span><a href=\"https:\/\/www.linkedin.com\/in\/mackenzie-jarvis-302118150\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\"> Mackenzie Jarvis<\/span><\/a><span style=\"font-weight: 400;\">, D.M.Sc., an instructor<\/span><b>\u00a0<\/b><span style=\"font-weight: 400;\">in the department of internal medicine and gastroenterology fellow at Atrium Health Gastroenterology and Hepatology. \u201cThese medications can move things faster and leave you without a clear answer.\u201d<\/span><\/p>\n<p><b>One day before<\/b><span style=\"font-weight: 400;\">, you must follow a strict, \u201clow-residue\u201d diet. It limits foods that are high in fiber, starches, carbs, and sugar. Jarvis says to avoid pasta, fruit, milk, cheese, grainy breads, ice cream, dairy products, and soda. You can still have chicken, fish, eggs, water, coffee, tea, and limited amounts of white bread and white rice (since they are low in fiber).\u00a0<\/span><\/p>\n<p><b>The day of the test<\/b><span style=\"font-weight: 400;\">, don\u2019t eat or drink anything aside from water (that includes breath mints and chewing gum).<\/span><\/p>\n<h3><b>During the test<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">The day of your test, you\u2019ll spend about two hours in the doctor\u2019s office. First, your physician will give you a sugar solution to drink. Jarvis gives her patients a glucose drink, and Mercy Medical Center gastroenterologist <\/span><a href=\"https:\/\/mdmercy.com\/centers-of-excellence\/digestive-health-and-liver-disease\/our-doctors\/other-gastroenterologists\/bryan-curtin-md\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Bryan Curtin, M.D.,<\/span><\/a><span style=\"font-weight: 400;\"> gives his patients either glucose, lactulose, fructose, fructan, or lactose. Glucose is the most typical.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">For the first hour after drinking the solution, you\u2019ll blow into a breath collection device every 15 minutes. It looks like a bag with a test tube attached. In the second hour, you\u2019ll blow into the device every 30 minutes. Dr. Curtin asks his patients to keep a diary of how they\u2019re feeling throughout the test, noting if they\u2019re having any symptoms. Meanwhile, lab techs will be analyzing the amount of hydrogen gas and methane gas in each breath sample you give.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cThe glucose gets broken down in the small intestine,\u201d Jarvis says. \u201cIf there are bad bacteria in the small intestine, it ferments, producing a byproduct of the glucose as hydrogen and methane. We read the study to see if there\u2019s an increase in hydrogen or methane past the baseline. If there\u2019s an increase in one or both, that will determine the treatment.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Some hospital systems use an at-home testing kit, but because of the equipment used and the very specific collection methods, it\u2019s not common yet.\u00a0<\/span><\/p>\n<h3><b>After the test<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Typically, patients receive their test results in about two weeks. Your doctor will analyze the results to see if and when large amounts of hydrogen or methane appear in your breath samples. Jarvis\u2019 office compiles the results into a graph in order to read them easier compared to the baseline sample.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">According to Dr. Curtin, if there\u2019s a hydrogen or methane increase of 20 parts per million or more, that signifies a problem. He also notes that \u201cif the patient develops diarrhea during the\u00a0test, the\u00a0test\u00a0is positive regardless of gas values.\u201d An increase in symptoms during the test signifies visceral hypersensitivity.<\/span><\/p>\n<h2><b>What does a hydrogen breath test diagnose?<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">A hydrogen breath test is mainly used to diagnose SIBO, or small intestinal bacterial overgrowth. But, it\u2019s also used to detect other digestive disorders such as:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Intestinal methanogen overgrowth (IMO)<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Abnormal digestion of dietary sugars<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Rapid small bowel transit time<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Hydrogen breath tests can help to diagnose <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/ibs-treatment-and-medications\/\"><span style=\"font-weight: 400;\">irritable bowel syndrome (IBS)<\/span><\/a><span style=\"font-weight: 400;\"> by identifying visceral hypersensitivity (or, acute abdominal pain\u2014a symptom of irritable bowel syndrome). They are a tool that can help rule out other conditions that might be causing symptoms that look like IBS.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">A recent <\/span><a href=\"https:\/\/jamanetwork.com\/journals\/jamaoncology\/fullarticle\/2681564\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">study by Imperial College London<\/span><\/a><span style=\"font-weight: 400;\"> recently found that hydrogen breath tests can also detect esophageal and gastric cancer in the early stages.<\/span><\/p>\n<h3><b>SIBO<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">If you\u2019re diagnosed with SIBO, or small intestinal bacterial overgrowth, it means that bacteria from other parts of your gut have started to collect in the small intestine\u2014and they shouldn\u2019t be there.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Symptoms usually include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Cramping<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Diarrhea<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Abdominal bloating or distention<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Nausea<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Abdominal fullness or discomfort<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Foul-smelling gas\u00a0<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">The treatment for SIBO is a round of antibiotics (usually <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/neomycin-sulfate\"><span style=\"font-weight: 400;\">neomycin<\/span><\/a><span style=\"font-weight: 400;\"> or <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/augmentin\"><span style=\"font-weight: 400;\">augmentin<\/span><\/a><span style=\"font-weight: 400;\">). Even with treatment, though, SIBO can come back, especially in patients with autoimmune diseases\u2014they may get SIBO as much as once a month, Jarvis says.<\/span><\/p>\n<p><b>RELATED: <\/b><a href=\"https:\/\/www.singlecare.com\/blog\/how-do-antibiotics-work\/\"><b>Antibiotics 101<\/b><\/a><\/p>\n<h3><b>IMO<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">IMO, or intestinal methanogen overgrowth, means that bad bacteria have piled up during a bout of constipation. You\u2019ll have all the same symptoms as SIBO, except with constipation instead of diarrhea. Treatment is similar, too\u2014a round of both general antibiotics and ones specifically for your gut, in addition to treatment for constipation.<\/span><\/p>\n<p><b>RELATED: <\/b><a href=\"https:\/\/www.singlecare.com\/blog\/how-gut-health-impacts-your-well-being\/\"><b>How gut health impacts your well being<\/b><\/a><\/p>\n<h3><b>Abnormal digestion of dietary sugars<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">This diagnosis means that you have trouble digesting sugars or dairy\u2014generally known as <\/span><a href=\"https:\/\/www.hopkinsmedicine.org\/gastroenterology_hepatology\/clinical_services\/specialty_services\/breath_testing.html#Fructose\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">fructose intolerance<\/span><\/a><span style=\"font-weight: 400;\"> (which includes the sugars found in onions, artichokes, pears, and wheat) or <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/what-is-lactose-intolerance\/\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">lactose intolerance<\/span><\/a><span style=\"font-weight: 400;\"> (the sugar found in milk products). This diagnosis, sometimes called malabsorption, also has similar symptoms to SIBO.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Unfortunately, these conditions don\u2019t have a cure. Instead, you can manage symptoms by eliminating certain foods from your diet. If you\u2019re lactose intolerant, some over-the-counter enzyme products, like <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/lactaid\"><span style=\"font-weight: 400;\">Lactaid<\/span><\/a><span style=\"font-weight: 400;\">, may help as well. Particularly for those with who cannot properly digest lactose, ensure you\u2019re getting enough calcium through supplements.<\/span><\/p>\n<p><b>RELATED: <\/b><a href=\"https:\/\/www.singlecare.com\/blog\/what-vitamins-should-i-take\/\"><b>What vitamins should I take?<\/b><\/a><\/p>\n<h3><b>Rapid small bowel transit time<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">If you have <\/span><a href=\"https:\/\/www.urmc.rochester.edu\/childrens-hospital\/gastroenterology\/tests\/breath-testing.aspx\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">rapid small bowel transit time<\/span><\/a><span style=\"font-weight: 400;\">, it means food moves through your small intestine at a quicker pace than normal, leading to diarrhea, abdominal pain, bloating, and flatulence. Depending on the underlying reason for your speedy transit time, you may only be able to <\/span><a href=\"http:\/\/ddc.musc.edu\/public\/diseases\/small-intestine\/dysmotility.html\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">treat the symptoms<\/span><\/a><span style=\"font-weight: 400;\">. Take antidiarrheals, avoid carbonated drinks, and skip out on foods that may cause excess gas.<\/span><\/p>\n<h2><b>How accurate are hydrogen breath tests?<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Hydrogen breath testing can sometimes give false positives, and, depending on the substrate used, can be more or less sensitive intended. Plus, some labs <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/16474100\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">use different parameters<\/span><\/a><span style=\"font-weight: 400;\"> for when to measure gas levels\u2014like taking breath measurements every 90 minutes for a longer test, or every 30 minutes from the start of the test\u2014which can lead to skewed results. At-home tests have even more room for error in the preparation and administration of the test.<\/span><\/p>\n<h2><b>How much does a hydrogen breath test cost?<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Costs for hydrogen breath tests vary, depending on both your healthcare provider and your insurance. The cash price can range from $145-$400. Check with your insurance plan to see if the test and any medications you need are covered. Or, talk to your doctor about ways to reduce costs.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Hydrogen breath tests are the most widely used, preferred option for diagnosing SIBO and IMO. A few more expensive, more invasive alternatives exist. One involves an upper endoscopy during which a doctor aspirates fluid from your small intestine. Another uses a capsule that you swallow\u2014it collects fluid that doctors use to then count the number of bacteria in the small intestine.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you think you might have SIBO or IMO, contact your healthcare provider to find out if the test is right for you.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Nausea, heartburn, indigestion, upset stomach, diarrhea\u2014this group of gastrointestinal symptoms can cause a lot of distress. And, they\u2019re often mysterious. It can be hard to pinpoint exactly what\u2019s causing all that tummy trouble. Enter the hydrogen breath test. This simple, non-invasive assessment measures gas levels in your breath to determine exactly why you\u2019re feeling those [&hellip;]<\/p>\n","protected":false},"author":85,"featured_media":12101,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[8029],"tags":[],"coauthors":[8371],"class_list":["post-10224","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-education","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>What is a hydrogen breath test and what do my test results mean?<\/title>\n<meta name=\"description\" content=\"A hydrogen breath test helps diagnose gastrointestinal problems (i.e., SIBO, IBS). 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