The best way to diagnose SIBO (small intestinal bacterial overgrowth) is by using the 3-hour Lactulose Breath Test that measures overgrowth of hydrogen and methane gas in the stomach.
Stool testing provides information regarding the large Intestine, and therefore has no diagnostic benefit with respect to the Small Intestine, which is where SIBO occurs.
However, stool testing can be beneficial as it provides an overview of which specific types of bacteria are overgrown in the stool, providing more clues about what type of overgrowth it might be (H.pylori, streptococcus, yeast overgrowth etc.).
Organic acid testing (OAT test) can also give clues, looking at other metabolic byproducts that are correlated to SIBO. Both OAT and stool testing are only indicators and are therefore not as accurate as the Lactulose Breath Test.
SIBO should therefore be diagnosed and treated based on the Lactulose Breath Test and perhaps in combination with a stool test.
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