Digestive symptoms such as bloating, abdominal pain, IBS, diarrhea and/or constipation, belching, and heartburn may be caused by an imbalance or overabundance of organisms in the small intestine. Different organisms produce as a by product of fermentation of carbohydrates and fiber various gases. This single breath test evaluates for the presence of 3 different types of gases, hydrogen, methane, and hydrogen sulfide to determine which type of bacteria are the root culprits. Described below are the implications related to the elevation of specific gases and what they reveal about the intestinal environment. This knowledge will help orchestrate a specific treatment plan to eliminate the underlying microbiome imbalances and improve the noxious intestinal symptoms.
What do the test results mean?
Elevated levels of hydrogen are indicative of SIBO.
- SIBO, or small intestinal bacterial overgrowth, suggests the presence of excessive numbers of bacteria(overgrowth) in the small bowel, causing gastrointestinal symptoms. The normal microbiome of the small intestine has minimal levels of bacteria, but when an overgrowth exists, symptoms like bloating, IBS, flatulence, belching and heartburn can occur.
- SIBO is often the result of complex and intertwined reactions arising from medications and conditions such as IBS, Celiac disease, Lyme disease, and several other gastrointestinal complications. The symptoms of SIBO can arise from the malabsorption of nutrients, alteration in intestinal permeability, inflammation, and/or immune activation that arises from the abnormal bacterial fermentation within the small bowel leading to fatigue, weight gain, headaches, and in some individuals rashes.
Elevated levels of methane are indicative of IMO.
- IMO, or intestinal methanogenic overgrowth, is an overgrowth of methane producing archaea in the small and large intestines. Methanogens are not bacteria (the “B” in SIBO) but are archaea and may also overgrow in the colon and not just the small intestine (the “SI ” in SIBO). In humans, excess methane production appears to be caused by Methanobrevibacter smithii, which is the predominant methanogen in the human gut.
- Elevated methane levels are associated with constipation, and the level of methane is correlated with the degree of constipation.
Elevated levels of hydrogen sulfide are indicative of excess hydrogen sulfide
- Excess Hydrogen Sulfide is a condition in which sulfate reducing organisms produce high amounts of hydrogen sulfide in the gut. Excess hydrogen sulfide was undetectable by traditional breath testing prior to trio-smart, and patients with excess hydrogen sulfide may have appeared “normal” on previous breath tests.
- Excess hydrogen sulfide is associated with diarrhea, and the level of hydrogen sulfide is correlated with the degree of diarrhea.
The Trio Smart is a breath test that you will complete at home. Your doctor will prescribe a lactulose prescription that you will pick up at your local pharmacy in order to complete the test. The kit will come with written instructions on how to complete the test. Ultimately, you will collect your samples by breathing into 9 collection bags over a 2 hour period. The first bag is considered a “baseline” sample and the remaining samples are collected after you drink a sugar substrate drink (lactulose). Once completed the samples will be sent to Trio Smart directly.
Dive further into the research by reading the following studies: