Our hospital used to provide hydrogen breath testing for the community but recently discontinued this practice. I was asked to comment on whether it should be discontinued and how often I used the test. It surprised me that I had not ordered a hydrogen breath test in the 2 decades I have been here but that many docs did. Although all of us are aware that small intestinal bacterial overgrowth can occur (e.g., scleroderma-type bowel motility disorders, post-operative blind loops, etc.), it seems that this diagnosis is being made more often in otherwise normal people without an obvious etiology.<\/p>\n
So the conversation I want to generate is the following:<\/p>\n
1) How often do you entertain a diagnosis of SIBO, and what symptoms\/settings make you consider the diagnosis?<\/p>\n
2) Do you think SIBO is being overdiagnosed or underdiagnosed?<\/p>\n
3) If you consider SIBO, do you do a diagnostic test, and, if so, which one?<\/p>\n
4)\u00a0Given that no test for SIBO is validated against a gold-standard diagnosis, how do you chose the test you are using?<\/p>\n
5) If you do not test for bacterial overgrowth, do you treat empirically, and, if so, with what?<\/p>\n
6) What test characteristics do you want to see before you would use a test for bacterial overgrowth?<\/p>\n
I look forward to the conversation!<\/p>\n
<\/p>\n
<\/p>\n","protected":false},"excerpt":{"rendered":"
Our hospital used to provide hydrogen breath testing for the community but recently discontinued this practice. I was asked to comment on whether it should be discontinued and how often I used the test. It surprised me that I had not ordered a hydrogen breath test in the 2 decades I have been here but […]<\/p>\n","protected":false},"author":28,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9,13],"tags":[],"class_list":["post-404","post","type-post","status-publish","format-standard","hentry","category-health-policy","category-patient-care"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/posts\/404","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/users\/28"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/comments?post=404"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/posts\/404\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/media?parent=404"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/categories?post=404"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/tags?post=404"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}