Its pretty funny actually. Hydrogen sulfide is a new gas being studied as a cause of SIBO Specific hydrogen sulfide test not available as of August 2019 (in development) Current Method to Detect First, test for SIBO using a breath test Second, verify the test was performed correctly: did you drink the solution, lab prep, etc. Those would be separate. DrAS: Ill just mention, if a person has a negative and youre thinking it could be hydrogen sulfide, the first thing to look at is to see if its a flat line test or hydrogen sulfide test. So again, we have Allison and Gary here. At the same time, it has antibacterial activity that may kill off both the unfriendly bacteria and the biofilms they live in. So thanks for that, Gary! Unfortunately, there is not as much research on this type of overgrowth and it can be challenging to manage and treat it effectively. Most people with hydrogen sulfide issues find that garlic, eggs, kale and other brassica vegetables like broccoli and brussel sprouts are the most problematic foods that promote their symptoms. Is it the air from the mouth? Although if Im remembering some of the details correctly, you oftentimes see an overlap between being traditional SIBO-positive and hydrogen-sulfide-SIBO-positive. It can be compounded, but you could also buy it over the counter. Id suggest finding a doctor who knows more about treating patients with IBS and SIBO symptoms. It's usually used as an antacid medication. DrMR: Well said. So when a patient presents and they have these chronic postprandial symptoms (as that definition is), then we know to test. Does your breath test simultaneously measure CH4, CO2, H2 and H2S? There are actually a couple of research studies, not about SIBO, that show that link. I have a colleague who tried using it for methane. I think it was originally for blastocystis. Where should we start this conversation? Two, if your test is negative, consider hydrogen sulfide. It wont hurt to test it out and see how your body reacts to it. Ive seen so many various prep guidelines out there. And it doesnt matter if you eat a hamburger or if you eat a pancake or if you eat something else. 2: Laxatives, stool softeners, stool bulking agents (Ex-Lax, Colace, Metamucil, Fibercon) . Regarding support, if youre not highly proficient in reading SIBO labs, Gary definitely offers the best clinical support Ive ever come across. Ive asked my GI doctor about prescribing resolor (procalopride) without seeing my in an appointment because our insurance isnt the greatest. This was really more like muscle pain, like that idea of fibromyalgia, and not as much joint pain, but more muscle kind of pain. 1, 2 Experts suggest non-invasive breath testing for the diagnosis of SIBO. So this is a non-validated test and a patient told me about it. Those with a homozygous (two bad copies) genetic mutation in an enzyme called CBS (Cystathionine beta-synthase) may also be at risk, as the CBS enzyme drives the recycling of sulfur-containing compounds. So thats bloating, abdominal pain, constipation, diarrhea. And oregano is a standard combination I use. So let me zoom us way out. There are also studies of using bismuth with antibiotics of your choice, really. And please correct me, Dr. Siebecker or Dr. Ruscio, if Im wrong, but you have to understand, these research centers have a different patient population than the clinician thats in private practice in Nebraska or New Jersey or New York or Florida. But these are the validations. When our body recognizes that we are low in sulfate, it can adapt and grow more H2S producing bacteria, since hydrogen sulfide gas and sulfite can be used to produce sulfate where its needed. So we cant see that gas, but the hydrogen is getting converted into hydrogen sulfide and no methane is being made (because methane also uses hydrogen). Does anyone know of a Dr who could treat all 3 types of sibo successfully?? In the case of hydrogen sulfide dominance however do you think this would be a bad option. So one of our Instagram posts went out today. However, we are, by and large, diagnosing SIBO based on the tried-and-true, time-tested, globally utilized hydrogen and methane breath testing, where we validate that from a gas perspective. Hear what the research says about their effectiveness. I wrote here on sulfur intolerance. Its a number of straws that have to be woven together to have strength and to be able to lead to that improvement that were looking for. Small intestinal bacterial overgrowth, also known as SIBO, occurs when you have an excessive amount of bacteria living in in your small intestine. GS: Yes, I absolutely agree with that. If your symptoms are severe, certain treatment options that reduce hydrogen sulfide-producing bacteria may also help, as well provide you with some symptomatic relief. Its most important, of course, to find the root cause. Zinc acetate has some research, and also soy isoflavones, and a Chinese herbal preparation. But I mean it medically. So moving on in the symptoms, Ive seen bladder irritation or interstitial cystitis. What did you specifically do? And then when I started going out to our normal time framesa minimum of two weeks, if not a monthand usually a month, then we were starting to see better results. I can go on. I think for the clinician who needs that feedback, this is a great service to the field. So thats the current state. Hydrogen-dominant SIBO causes diarrhea. Its not a study. It has nothing to do with flat line. Background & Aims: Hydrogen sulfide is one of the main malodorous compounds in human flatus.This toxic gas also has been implicated in the pathogenesis of ulcerative colitis.Therefore, a treatment that reduces colonic H 2 S levels could be clinically useful in the treatment of flatus odor and of ulcerative colitis. These are the types of gases that are measured on a breath test. And there are different treatments for hydrogen sulfide. Intestinal gas can either come from swallowed air, which is termedexogenous gas, or from the bacteria that reside within our gastrointestinal tract which is calledendogenousgas.1. Guess what? If they do, then we yield to Dr. Siebeckers work here, and weve been validating that they are hitting on one or more of these. And this is really disheartening, because then these patients end up getting treated and treated and treated and treated, never to really feel much different or see their labs changed, because they were treating a false positive all the while. It's used to help diagnose common digestive problems, including SIBO, IBS and lactose intolerance. Maybe we should start with defining hydrogen sulfide SIBO for people who havent heard of it Im sure most of our audience has. Small intestine aspirate and fluid culture. DrAS: Sure. We have patients that have heavy doses of laxatives that can sometimes flush. And if we hit that mark, I think weve helped people with this podcast, and Im pretty confident that weve done so. So I went hunting. Ive seen phenomenal successes. It is also used to treat diarrhea and help prevent travelers' diarrhea. Because were throwing out a lot of details here and I think the clinicians are probably loving this. This is what we do. They were both saying, you just treat it the same way you would have before, you treat the presentation, meaning constipation versus diarrhea. Their patient populations are so different. Sorry to dump so many things for the folks listening here, but these are important factors when we talk about this. And we do have a way to interpret hydrogen sulfide currently in breath testing. Thats just to name a few. Additionally, by eliminating the high sulfur foods from your diet, you will also be able to test out how your body responds to different foods that contain high amounts of sulfur when reintroducing them later. Lets use the flat line. So is it a I have a positive SIBO, Im just going to check on the hydrogen sulfide symptoms, the tingling of the hands and feet, the photophobia and intolerance, all the things that youve already reviewed? Additionally, although meat contains a large number of amino acids, such as cysteine and methionine, which contain sulfur, most people have been shown to tolerate meat well in normal portion sizes. And at the end of the 60-second video, we provide a link with the specific probiotic recommendations based upon this gut-brain connection. And lets not call up the lab (I dont know if theyre in Germany) where theres a urinary hydrogen sulfide test and put all of our eggs in that basket. It might be yeast overgrowth. But we dont want to confuse these patients. That seems to be a little bit better tolerated for a lot of people. And yes, there is some newer information, possibly some newer devices that we could augment to improve it even further. No, berberine is not that only or main antimicrobial for h2s. Which is, yes, we need to help weed out some of the things that we dont want there, but we also have to support the gut ecosystem, if you will, to encourage balance. But by and large, were having a lot of success based on everything that weve discussed. And thats the case for absolutely everything Ive ever used to treat SIBO. GS: Can I just ask a question? Outdoors, H2S is naturally present in crude petroleum, natural gas, volcanic gases, and hot springs. These include brain fog, memory issues, redness, fatigue, and other problematic digestive symptoms like diarrhea and constipation seen in IBS. This does come back to a philosophy of improving ones gut ecology. Find everything you need to know about Pepto-Bismol (Bismuth Subsalicylate), including what it is used for, warnings, reviews, side effects, and interactions. And I just monitor Instagram periodically, but I replied on this one and said, Really? And guess what the number one reason is for a flat line test? Its just that weve been doing it and were in excess of, as I mentioned, over 34,000 tests. How do you know if you have SIBO or dybsosis/ hydrogen sulfide issue? So a lot of them have this. The movement of these gases does not cause us any pain or discomfort, and will eventually be released in small amounts. We talk with clinicians every day and we call on every single flat line test, whether its a glucose or lactulose, we call on it. This isnt a long-term solution, but if you do have hydrogen sulfide-producing SIBO, it will likely help alleviate symptoms. Well, Gary, Allison, thank you for this roundtable. Theyre seeing the sickest of the sick. And as with many that are listening (and those here on this podcast), we always look forward to new technologies, new approaches to evaluating SIBO, and whether or not there are applications to that in treatment. As an Amazon Associate I earn from qualifying purchases. But Im unclear and wary as to whether we need to really make our SIBO treatment that much more complicated. I recently had the opportunity to sit down with Dr. Greg Nigh a Naturopathic doctor fromPsoriasiswho was able to clearly explain this process, as well as provide some insight as to why he believes that sulfur metabolism plays a role in H2S SIBO. Green tea is well documented with research showing it reduces hydrogen sulfide gas by 30%. Thats where, when many treating clinicians are requesting, Where do I go for these answers? I send them to the experts. So the problem is not on the clinicians, not on the patients. Since a majority of the gas in the body will be H2S, this may be why a traditional breath test will show little to no hydrogen or methane and will look like a flat line. If you are experiencing the symptoms associated with hydrogen sulfide overgrowth, there are a few things you can consider and do to help your body. Causes include heavy metal toxicity as well as potentially glyphosate toxicityglyphosate is the active ingredient in the herbicide Roundup. I would also contrast with this list of symptoms. The lab has to say, when were going to deliver a result to a clinician, if its flatwhether its glucose or lactulosedo I call that clinician, have that conversation? Unfortunately, there are no clear SIBO treatment guidelines, and more research on the use of antibiotics for SIBO is still needed. Or what are your thoughts about just adding in some bismuthor something like thatto your approach to treating SIBO, generally speaking, based on the fact that we cant measure hydrogen sulfide right now, and you dont know youre dealing with it? So maybe its pushing someone towards constipation. So were seeing this really play out. A hydrogen breath test is a fairly simple, noninvasive way to check for sugar intolerance or SIBO. buff.ly/3JsH0FZ. And many GI's are not aware of that and simply prescribe course after course of Rifaximin. They offer accounts for clinicians and direct-to-consumer testing. 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