Lactulose malabsorption testing

My experience undergoing Lactulose testing in order to create a SIBO profile

Why Get Tested?

After my Fructose malabsorption test came back positive, and I had seen a talk on SIBO (Small Intestine Bacterial Overgrowth) by Dr Jacobi at the Woodford Folk Festival that resonated with my symptoms, I knew it was a path I needed to explore further. Lactulose is seen by some as the best indicator of SIBO, so the Fructose malabsorption Test results alone were not enough to determine that in fact, SIBO was my issue. Through the Australian Medicare system, you can only have one hydrogen breath test a month and I was being charged at $150 per test. Alternatively, I could order the test privately through sibotest.com and if I also ordered the Glucose Test, it worked out at the same price and I could get the results a lot sooner. When you feel horrible every day, diagnosing your issue sooner rather than later is almost priceless.

Preparation

The test is normally posted out, however as I live close by to the clinic, I was able to do local pick up and drop off. Now I just had to complete the preparation diet and testing could be under way. There are preparation guidelines and an instructional video on the website to guide you on how to complete the test. As I had recently had coconut yoghurt, I had to wait a few days before it had been a week between consuming probiotics and performing the test. Adhering to the guidelines and ensuring nothing prohibited sneaks into your diet must be ensured. I thought I was right as rain as I had ceased taking probiotics before my Fructose malabsorption test, however forgot that going back to my regular diet of coconut yoghurt meant that I was still ingesting these bacteria. Once I had eliminated probiotics and fermented foods for a week, had only consumed white basmati rice, boiled eggs and parmesan cheese in the 36 hours before the test and had a period of 12 hours of fasting just prior, almost everything was ready for testing to commence. A benefit of doing the test privately at home was that I didn't have to adhere to an appointment time and could wait until I had a bowel movement, as recommended, before conducting the test.

The Test

I prepared the Lactulose solution, an orange liquid mixed with water that tasted slightly sweet and reminded me of the dentist. Before consuming the solution, I completed my first breath to get my baseline reading. I was doing it alone and not in front of a mirror, so was unsure that I had done it correctly as I didn't really know what to expect. I couldn't see the air had entered the tube and I didn't even know if I had pierced the capsule properly, so I cheekily did the baseline breath again, this time being watched by my family so they could confirm the needle was entering the tube and my breath was actually going in.

I then consumed the solution and commenced timing. Conducting breath collections every 20 mins for the next 3 hours, a total of 10 samples by the end. I didn't consume anything during this time, though some water is allowed. You also aren't allowed to do vigorous movement, so I spent the time surfing the web and reading. 3 hours of forced quiet time was a good thing, an the time actually went by very quickly, by the time I had collected the breath sample, written up the label, taken a photo of my belly to see if bloating could be detected and at what point in time post lactulose ingestion, there was many minutes left before the timer was going off and the next sample required. Once completed, I packaged up the samples and dropped them back to The Biome Clinic.

Results

Once the samples had been analysed, the results became available in my online patient portal. Another perk of private testing, I could get the results as soon as they were available and not have to wait, or fork out the money for, a GP appointment. I was so eager to see what had been found, but unsurprisingly disappointed with what I was presented. To keep things consistent with my inconclusive Coeliac Disease testing, my test results came back with two negatives and a borderline.. sigh. No, I didn't actually want to have SIBO, but in a way I did so that I could finally have an answer, a diagnosis, of what was going on in my body.

Full Lactulose Lab Results

So although it was initially suggested that I wouldn't need to do the Glucose Malabsorption Testing, because I now had a positive Fructose Malabsorption test result and an unclear Lactulose Malabsorption test result, to get a more confident SIBO profile, I was encouraged to do the Glucose testing also.