Which IBS Test is right for you?

Fructose and lactose breath testing are standard in all patients with IBS and should be performed first. Testing for malabsorption of other sugars e.g. glucose, sorbitol and mannitol, should be considered in patients with normal breath tests for fructose and lactose, or if symptoms fail to improve with restriction of fructose/ lactose intake. Testing for both glucose and lactulose malabsorption is recommended for investigation of suspected small intestinal bacterial overgrowth (SIBO).

Lactulose
  • Is a synthetic sugar unable to be absorbed by the body
  • Is compulsory baseline test to exclude H2 non-producer.
  • To determine oro-caecal transit time.
  • Is an indicator for the necessity of the SIBO test.
Fructose
  • Fructose is a single molecule sugar (monosaccharide) present in many fruits as well as honey and onions.
  • For Fructose malabsorption and recommended in all IBS patients, especially those with symptoms related to fruit ingestion.
Lactose
  • For lactose malabsorption (lactase deficiency), recommended in all IBS patients, especially those with symptoms related to milk/dairy products
Glucose
  • Recommended for investigation of proximal and distal small intestinal bacterial overgrowth (SIBO)
Sorbitol
  • For suspected malabsorption of sorbitol, found in some fruits (e.g. stone fruits) and as a sweetener in sugar-free foods
Sucrose
  • For suspected sucrose malabsorption (sucrase-isomaltase deficiency). Sucrose is found in processed foods, fruits and vegetables
Mannitol
  • For suspected mannitol malabsorption, particularly in vegetarians. Mannitol is used as a sugar substitute (in vegetarian food, chewing gums, breath mints, and sugar free lollies) and also occurs naturally in some vegetables e.g. cauliflower, mushroom and watermelon.
Fructan (Inulins)
  • For suspected fructan malabsorption. Foods that are high in fructans may include wheat products (such as bread, pasta), onions, shallots, garlic, barley, cabbage, broccoli, pistachio, artichoke, chicory root, and asparagus.
 

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