Friday, 1 August 2014

SIBO Hydrogen Breath Testing

I have recently had a decline in my current health. 
(hence why I haven't really been posting very often...)

For whatever reason, since I tried to introduce probiotics to a system that is dying for it, I have had such a worsening of symptoms that I might as well have not lived through this past year! 
It had taken many weeks of trying different types, different doses etc before I finally gave up. 
My nutritionist thought it best to have lab tests done again. 
This is for two reasons: firstly, it has been a year and this is a great amount of time to find out if any of my markers have changed for the better in that time (my sIgA levels, Lysozyme, Chymotrypsin and my microfloral levels... I don't know what those words mean either!)
And secondly to detect whether or not we are dealing with a particularly stubborn Small Intestinal Bacteria Overgrowth that just refused to die.
This is sad, but also I am hoping so much that the results are 'bad,' just because I feel so awful again! Then we can take steps to tackle it, even if that means a really restrictive diet again! As I remember how hard it was the first time round, I can't say I'm jumping for joy!

However, as part of this round of testing we have included a Hydrogen Breath Test, which detects SIBO in breath samples. Since this is quite a unique experience, I wanted to blog about it! Who knows, it may help someone feel less intimidated by the scary rules that it involves!

After arranging payment with the lab I received my home test kit. The good thing about these private tests is that you can do them in the comfort of your own home. Thank goodness, because collecting multiple stool samples over a week can be quite traumatic for the uninitiated (but hey, that's an entirely separate blog post!)
I was sure to read and read and read the instructions carefully, so I knew exactly what to do. I also had some great advice from my nutritionist about what to include in my diet the day leading up to the test as this is very important! They do provide some documentation but it is very basic, so I was grateful to have an expert to guide me on this. In order for the results to be as accurate as possible you must not eat fibre, most grains and slow digesting foods for the day before and you must fast for 14 hours before the test commences.

Since a 14 hour fast is close to hell for me (my hunger levels have been through the roof lately, coinciding with the return of my horrible symptoms!) I chose to include as much sleep as I possibly could during the fast. I wanted to complete the test before work in order to not book time off, but the test takes 3 hours to complete (which essentially is a 17 hour fast..but who's counting?!) \To fit it in I had to be awake for 5am, meaning a fast beginning at 3pm on the day before! Ouch.

I kept my foods extremely plain the day before the test, taking a roast chicken to work with me for lunch as I knew I would have to last the evening with just water.

It really wasn't as bad as I thought it would be!

It is best to read the instructions really carefully

On the morning of the test, bright and early, I laid out all the bits of equipment in order to be as efficient as possible. The test involves ingesting a dose of Lactulose (a non-digestable sugar) that will react with the SIBO and give off the gas Hydrogen, which is then measured in breath samples taken every 20 minutes for 3 hours. In the test kit were 10 sample 'pouches,' including one for your 'fasting breath,' and the breath test apparatus which you assemble yourself.

Some assembly required

This is a tricky shape, but it will fit into the mouth piece with some wriggling!

I mixed my lactulose with 200ml of water as instructed and laid out my pouches in order. I assembled the breathalyser and waited until 5:30am, as the instructions state to not sleep for 30mins prior to your first sample.

A fasting breath sample is basically a sample taken as you are, before the lactulose, for something to measure the results by.
The little pouches are quite tricky at first as they must be sealed tightly before too much air escapes! It can take a few practices to get your technique nailed, which I thought best to do with the fasting sample before results were involved! You must try to collect the last 1/3 of your breath, the last of the air out of your lungs. I practised breathing before the test started in order to get a feel for when this was. I really pushed all my breath out of my lungs!

Once a fasting sample is collected, drink the lactulose mixture and wait for 20 mins before the first sample is collected. I set my timer on my iPhone every time, it made it so much easier and actually seemed to make the whole process slip by!

With everything laid out in order I was able to get through samples quickly and easily. The instructions say not to exercise, eat or smoke during the collection period and to only resume quiet, gentle activities. I set about making my breakfast and lunch for work, stopping every 20 minutes for the next breath.

Within no time at all the last sample was collected and the test was over! I have never eaten breakfast so fast (which gave me trapped wind all day!! D'oh!)

Pack the samples back in the box when you're done!

You must post the completed test as soon as you can after finishing, by special delivery. 

I am not sure what the effects of the lactulose were, I had a pretty painful day that day but it could have been the fasting that tripped me up somewhat.

I am so excited for the results. I truly hope I can get to the bottom of this health enigma. It is hard not to get upset when you feel like you've followed all the rules and given up so much in order to be healthy, and it seems your body has other ideas! I really hope me and my bowel can be on the same team again soon!
The most frustrating and rewarding thing about this whole journey to wellness has been the treatment of my anxiety surrounding my poor digestion. I am able to separate 'myself' from my 'symptoms' and no longer suffer panic attacks. I go out more and find the whole process of visiting new places easier than I ever have. But in some ways this is sad, because my head is so ready to take on the world and get my life back, but my bowel has not caught up!

As well as this test I also undertook a lab stool test, called an Gastro Intestinal Panel.

I should be getting the results of both tests through my nutritionist in about a week, so wish me luck! And, oddly, wish me some bad news! ;)  

I hope this was interesting, or helped those of you who might be facing this test in the near future! 

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