Gastroenterology - Breath Test for small intestinal bacterial overgrowth

This leaflet has 3 aims:

1. To help you become better informed and more involved in your care.
2. To explain what happens on the day of the procedure.
3. To answer some of the questions commonly asked about the procedure.

If you have any questions, access or communication needs such as an interpreter please contact the department stated on your appointment letter.

Reasonable adjustments will be considered for all disabled users of this service.

Please make sure that you read the following information CAREFULLY, as you will be required to avoid certain foods prior to the test.

A non-invasive hydrogen breath test has been requested for you to assess if you may have bacterial overgrowth. Symptoms of bacterial overgrowth can diarrhoea, nausea and sometimes abdominal discomfort. We all have bacteria in our large intestine (colon) but sometimes this bacteria can move into the small intestine. If the test is positive the usual course of treatment is antibiotics.

We all have hydrogen in our breath but more so if bacterial overgrowth has occurred. It is the breath hydrogen concentration that will be tested.

What will happen to you during this test:

• The test will take approximately 2-3 hours
• The physiologist will take breath samples from you by asking you to breathe in to a machine
• You will be given a test meal of a small dose of glucose. Occasionally we will use lactulose
• Breath samples will be taken from you every 15 minutes
• The test is not invasive or painful
• Please feel free to bring a book or newspaper with you

What you need to do prior to the test:

• Do not have anything to eat or drink (except water) for 12 hours prior to the test. *Please drink a glass of hot water before you set out on the day of the test*
• Avoid slow digesting foods i.e. high fibre foods for 24 hours prior to the test.

The following are suggested foods that you CAN eat:

ALLOWED
✓    Cereal including cornflakes and rice crispies, but not Bran
✓    White bread or toast with butter/margarine, eggs, bacon.
✓    Plain strained soup
✓    Meat or fish (no batter or breadcrumbs), potatoes with no skin.
✓    Tofu & Soya
✓    White rice, noodles or white pasta
✓    Rich tea or other plain biscuits
✓    Sugar or sweetener
✓    Jelly
✓    Water, cordial, fizzy drinks

AVOID
X High fibre cereals, including anything containing bran X Fruit
X Wholemeal or seeded bread
X Wholemeal/brown rice, wholemeal/brown pasta X Pulses (beans, lentils) or nuts/seeds
X Vegetables with the skin on (e.g. jacket potato skins) X Crisps
X Roasted or deep-fried chips
 
If you have diabetes, please use this glucose meal as your breakfast, and adjust your diabetes medication accordingly. (75g glucose is equal to approx. 7 slices of toast).

Please take your diabetes medication as you normally would with this in mind.

We may need to check your blood glucose at some stage during the test, you can bring your blood glucose monitor to the appointment with you.

If you have any concerns, please contact your diabetes nurse for further advice.

• Please contact the department if you have taken antibiotics within the last 4 weeks as this will affect the test
• Do not smoke within 12 hours of the test
• Eating, drinking, smoking, sleeping and exercise are NOT permitted during the test

Medications

If you take any of the following medications for your bowels please stop for 3 days prior to the investigation.

Maxalon, Metoclopramide, Mebeverine, Gastrobid/Gastrmax, Alverine, Peppermint Oil, Loperamide (Imodium) and any laxatives or similar such as Senna, Dulcolax, Movicol, Prulcalopride, Linaclatide (Constella) or Fybogel etc

There are no known risks associated with this non-invasive breath test for bacterial overgrowth, however it may bring on your symptoms. However, if you are diabetic, please contact the department and further instruction will be given to you regarding fasting and the test itself.

There is no alternative to this investigation other than not going ahead with this investigation.

If you have any questions, please contact the department on your appointment letter.

Smoking Policy

Northern Care Alliance operates a smoke free policy. To find out what this means for you, pick up the leaflets available at the hospital. For advice on stopping smoking contact 0161 212 4050.