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Beyond Breath Testing: Using the GI-MAP to Uncover the Other Players in SIBO

Friday, July 23, 2021
by Amy Rolfsen, ND


SIBO is on the top of everyone’s mind these days. In this blog by Dr. Amy Rolfsen we review why SIBO breath testing by itself just isn’t enough. To design an effective treatment protocol the first time, we need the whole picture of gut health, including digestion, immunity, commensals, pathogens, opportunists, and more. There are many useful scientific tidbits in this well-referenced blog, and I hope you read, comment, and share! Enjoy! –Dr. Kara Fitzgerald


Small intestinal bacterial overgrowth (SIBO) describes the state of abnormal concentrations of bacterial and/or archaeal growth in the small intestine. Although the classic definition of SIBO refers to the overgrowth of commensal organisms, opportunistic, and pathogenic organisms are often involved.

The current diagnostic standard for SIBO within the medical community is a three-hour lactulose breath test. This test is useful in identifying dysfunctional gas production in the upper gastrointestinal (GI) tract. Beyond gas production, however, the lactulose breath test does not provide a complete assessment of GI function and other infections. Many clinicians will stop searching when a lactulose breath test comes back with positive findings. However, the absence of deeper assessment of the gastrointestinal health of our patients is one of the biggest pitfalls in the long-term management of SIBO cases.

Most clinicians are acutely aware of the common SIBO symptoms and associated clinical conditions. Still, it can be puzzling when patients return with an incomplete relief of symptoms despite reasonable SIBO protocols. These persistent cases are all too common. In these situations, your practice and your patients could benefit greatly from GI-MAP’s deeper investigation into GI ecology, microbiome status, and assessment of digestive health.

Read the rest of the article at DrKaraFitzgerald.com and learn about Using the GI-MAP (Gastrointestinal Microbial Assay Plus) to Clarify SIBO Cases.

Discussion points for assessing GI-MAP for common SIBO findings include:

  • Identifying Hydrogen (H2) Producing Organisms
  • Identifying Methane (CH4) Producing Organisms
  • Identifying Hydrogen Sulfide (H2S) Producing Organisms
  • Underlying Causes of SIBO
  • Helicobacter pylori
  • Digestive Insufficiency
  • Low Immunity
  • When SIBO is More Than Just SIBO
  • Pathogenic Bacteria
  • Yeast/Fungi
  • Parasites
  • Deficient Normal Flora
  • GI Lining Dysfunction
  • Blood, Inflammation, and Inflammatory Disorders
  • And References to Works Cited


About the Author

Amy Rolfsen, ND

Dr. Amy Rolfsen is a naturopathic physician, speaker and medical educator with a deep focus on the gut microbiome and gastrointestinal health. Her main passion is education, sharing her clinical expertise, and up-to-date research with fellow medical practitioners.


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