Our consultation includes the clarification of complaints with the help of breath tests. Breath tests are a good way to further clarify gastrointestinal conditions non-invasively.

Hydrogen breath tests (H-2 breath tests) offer the possibility of clarifying lactose intolerance and fructose malabsorption (also secondary type due to a disturbed microbiome) and bacterial overgrowth of the small intestine (SIBO = syndrome of bacterial intestinal overgrowth).

SIBO is one of the most overlooked and underdiagnosed conditions and a common cause of irritable bowel syndrome (IBS). Here, an “overgrowth” of the small intestine by various intestinal germs is prevalent. The small intestine is normally relatively low in germs compared to the large intestine. The colon germs, the overgrowth, form gases from food residues (nauseous = putrefaction, odorless = fermentation), which cause the symptoms. The liver can also be stressed by toxic substances produced by the intestinal germs, which is called autointoxication (sometimes a cause of unclearly elevated liver values).

Frequently, a vitamin B-12 deficiency is also present in SIBO. This can lead to numerous other symptoms (fatigue, anemia, nerve sensory disturbances, gait instability, increased homocysteine levels, burning of the mucous membranes, depression, etc.). In SIBO, symptoms often occur immediately after eating. Common symptoms include bloating, regurgitation, heartburn to a feeling of tightness in the chest (Roemheld syndrome).

Millions of people suffer in silence for years while the effects on digestion and the immune system are devastating. Sufferers are often exhausted, have constant pain and sleep disturbances, and fear food and social situations (going out, public places, traveling, etc.). A SIBO is extremely stressful physically, emotionally, and mentally.

Likewise, tests for lactose intolerance and fructose malabsorption can be false positives in the context of a SIBO, leading to the recommendation of unnecessary, sometimes lifelong avoidance of these foods. SIBO must be treated first, and only then should tests for lactose intolerance and fructose malabsorption be performed.

We perform H-2 breath tests with glucose (SIBO upper small intestine) and lactulose (SIBO middle and lower small intestine) for clarification. Both breath tests are necessary. Therapy can be with chemical and/or natural antibiotics and general measures and has good response rates. I try to work primarily with natural agents and only resort to synthetic substances in extreme cases, as these can also be problematic.