# What are your breath test results?



## Moises (May 20, 2000)

I am curious. Pimentel states that, over time, those with SIBO have two peaks in the exhalation of methane or hydrogen. The first peak is when the lactulose hits the small intestine, the second peak is when the lactulose hits the large intestine.For those of you who have had before and after breath tests, I assume you had two peaks before treatment. My question is how many peaks did you have after treatement?I know that normal people (people without SIBO) show one peak when the lactulose hits the colon. But if you have just been treated (either with antibiotics or with an elemental diet) then, by hypothesis, _all_ enteral bacteria have been eliminated. After all, Pimentel argues that rifaximin and neomycin remain within the lumen and have negligent absorption into the bloodstream. Hence they would kill all bacteria in the colon as well as in the small intestine. Likewise, according to Pimentel, the mechanism by which the elemental diet works is starvation of enteral bacteria. The elemental diet cannot selectively starve the small intestinal bacteria while the colonic bacteria live on. So, the elemental diet, like antibiotics, nonselectively eradicate all enteric bacteria.If the SIBO treatments eradicate all enteric bacteria, then, immediately following successful treatment for SIBO, there should be no bacteria in the gut. If there are no bacteria in the gut, there should be nothing in the human body that releases hydrogen or methane as the byproduct of metabolism. If there is nothing in the human body that produces methane as the byproduct of metabolism, then breath test results should show a flat line. Breath test results should demonstrate that no methane or hydrogen is being generated because there are no bacteria in the body to produce these gases.Pimentel does say that intestinal bacteria reproduce at a phenomenally fast rate. Some of them double in volume in 20 minutes (page 102). So the "after" breath test would have to occur before the treatment phase ceased.If you have had breath tests, did you have a peak after you were cured?


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