Hydrogen & Methane Breath Testing

vs Small Bowel Aspiration: A Comparison of Diagnostic Tests for Small Intestinal Bacterial Overgrowth and Carbohydrate Malabsorption Disorders


Gastrointestinal disorders and their symptoms affect millions of people in the United States each year, and the effects of these symptoms can be discouraging for patients. Even worse, Small Intestinal Bacterial Overgrowth (SIBO) and other maldigestive disorders can be difficult to diagnose; sometimes patients could end up with more than one diagnosis and could have an illness that does not follow a typical course.

Primary care physicians, gastroenterologists, integrative and naturopathic doctors must use a combination of patient history (asking questions), ordering medical tests, and eliminating specific disorders before coming to a correct diagnosis. For patients that present with symptoms of SIBO, The North American Consensus of Breath Testing, the only standardized guidelines agreed upon by 17 independent clinicians, states that hydrogen & methane breath testing and small bowel aspiration are the typical courses of diagnosis.

There are significant differences between these two types of SIBO diagnostic tests, and the following comparison should be taken into consideration when choosing a diagnosis plan:

Small Bowel Aspiration:

Historically, small bowel aspiration was considered the “gold standard” for SIBO diagnosis, but it has multiple drawbacks including being an invasive procedure that must be performed in a medical facility and requiring patient sedation and monitoring. While the test itself is fairly safe, any invasive medical procedure with sedation comes with some risk. Additionally, small bowel aspiration is costly with doctor fees, anesthesiology fees, and facility fees. Obtaining insurance coverage may also be challenging for small bowel aspiration depending on the patient’s coverage.

Breath Testing:

New research and guidelines have been published by the American College of Gastroenterology and other researchers to bring standardization to these types of diagnostic tools. Breath testing is non-invasive, safe, and cost effective (typically a max out-of-pocket cost of less than $200) if the test is not covered by insurance. While breath testing can be performed in a medical facility, it is most often performed in the comfort of a patient’s home using an at-home diagnostic test kit.

The North American Consensus of Breath Testing states that “current small bowel culture techniques are not satisfactory for the assessment of SIBO” while breath testing “is a useful, inexpensive, simple and safe diagnostic test.” Especially in a COVID-19 environment, at-home breath tests can be combined with telehealth visits to keep patients safe and comfortable without increasing stress and anxiety from in-office visits and procedures.

Commonwealth Diagnostics International’s (CDI) FDA registered, CLIA-permitted breath testing products for SIBO and malabsorption disorders are both non-invasive and can be taken at home. Our delivery model is easy and efficient, and we can typically onboard a practice the same day--there is no account set up needed. Healthcare providers can easily order a test kit online to be shipped directly to a patient’s home. For more information about ordering from CDI, go to https://www.commdx.com/order-kits.php or contact customer service at customerservice@commdx.com or 888-258-5966.