Frequently Asked Questions
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Which breath test is right for me?
You can book a breath test without a doctor’s referral. If you are referring yourself for a breath test, and are unsure which breath test you need, use the table below as a guide:
Lactose Breath Test (to test for lactose intolerance) Recommended for all IBS patients. Recommended for patients who suspect they get symptoms from eating dairy foods such as milk, yoghurt, soft white cheese, ice cream Fructose Breath Test (to test for fructose intolerance) Recommended for all IBS patients. Recommended for patients who suspect they get symptoms from eating foods such as fruit (eg apples, pears, mangos), vegetables, honey and high fructose corn syrup. Sorbitol Breath test Recommended for patients who suspect they get symptoms from eating stone fruits and artificially sweetened mints/chewing gum. Sucrose Breath Test This is a rare form of malabsorption and should be considered only if other sugar malabsorption and small bowel bacterial overgrowth have been excluded. This is intended primarily for children. Xylitol Recommended for patients who experience IBS-type symptoms and regularly consume “Diet” and “Sugar Free” foods and beverages including artificially sweetened gum and mints.” Methane Breath Test This is included free in your hydrogen breath test Choosing can be difficult. If you’re unsure, consider seeking advice from an Accredited Practicing Dietitian
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Will I feel unwell during the breath test?
We aim to make your time at The Breath Test Lab as comfortable as possible. If you are indeed intolerant to the sugar you are being tested for, you may experience the symptoms that you are investigating, i.e. nausea, abdominal cramping and bloating and possibly even diarrhoea. These symptoms aid us in confirming your intolerance and while they are unpleasant, are not dangerous to your health. Symptoms may may persist for up to 24 hours, depending on how long it takes your body to clear the sugars.
People with asthma or lung diseases should bring their inhalers or relieving medication (eg Ventolin®), as repeated breath sampling may uncommonly trigger an attack.
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Do I need to take a day off?
Most Hydrogen & Methane Breath Tests go for 2-3 hours, so you don’t need to take a day off work. Our clinic opens at 8am so that you can be in and out of the clinic before midday. We are also open on Saturdays (see our opening hours on our contact page).
Some patients may choose to take the day off work if they develop abdominal discomfort or gastrointestinal symptoms. We will happily provide you with a discrete certificate of attendance to provide your employer.
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What does Hydrogen and Methane Testing involve?
You can book a Hydrogen & Methane Breath Test without a doctor’s referral.
The Breath Test Lab provides on-site, accurate hydrogen & methane breath testing. Hydrogen & Methane breath testing is a non-invasive test which does not involve any blood collection. Each test takes about 2-3 hours and is safe for people with diabetes, pregnant women and children older than 10 years.
The test is simple and involves the patient following a specific diet leading up to the test (see How do I Prepare for my Hydrogen & Methane Breath Test for more information). The testing involves drinking a specifically prepared carbohydrate solution specific to each test:
- Lactulose
- Fructose
- Lactose
- Sorbitol
- Xylitol
Breath samples are taken at regular time intervals to measure Hydrogen & Methane in your breath using a special analyser. Elevated levels indicate malabsorption of the tested carbohydrate.
You may choose to have multiple tests done if you think you have several carbohydrate intolerances, or if the earlier tests have not demonstrated an intolerance. It is important to note however, that tests need to be performed on different days with at least 2 days in between to allow your bowel to return back to its baseline.
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Prepare for your Hydrogen & Methane Breath Test
4 Weeks before the test
- No antibiotics. Please do not stop any antibiotic treatment without the approval of your treating doctor.
- No Colonoscopy or Barium Meal Enema procedures
One day before each test
Do not consume:
- Any wheat products- bread, pasta, bran, cereals, whole grain products
- Any food lactose containing foods – cheese, yoghurt, ice cream, chocolate, milk(lactose free milk, soy/rice/almond/coconut milk are fine to drink)
- Oats
- Onions
- Garlic
- Legumes (lentils, chickpeas, kidney beans, chickpeas
- Peas
- Cabbage
- Canned fruit
- Fruit juice
- Dried fruit
- Honey
- Alcohol
- Sports drinks
- Soft drinks
- Corn
- No laxatives
- No Fibre supplements (E.g Metamucil)
Please see our suggested Meal Plan for what you can eat in the 24 hours leading up to your test
FAST from 9pm the night before.
This means nothing to eat or drink except plain water. You can continue to drink small amounts of plain water prior to starting your test
Morning of your test:
No smoking
Continue to fast
- How do Hydrogen Methane Tests Work?
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Where can I Park?
Street parking can be quite difficult in Randwick.
The Royal Randwick shopping centre offers two hours free parking – the entrance is off Avoca Street
The Randwick Plaza Shopping Centre (Coles) has 1.5 hours free parking with a receipt from the centre – the entrance is off Clara Street.
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How many sugars can I test?
In order to ensure a valid and specific result, each Hydrogen & Methane Breath Test can only test a single sugar at a time. However, as long as you leave at least 2 days between tests, you are able to test as many sugars as you or your health practitioner feel are necessary.
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Why do I have to do a baseline test in addition to the requested sugar?
The baseline test permits us to provide a more accurate and reliable result by allowing us to screen for possible bacterial overgrowth, which could otherwise lead to a false diagnosis of carbohydrate intolerance. This is important because bacterial overgrowth requires medical treatment and cannot be treated by diet or probiotics alone.
Furthermore, the baseline Lactulose Test allows us to measure the time it takes for sugars to reach the colon. This information guides the interpretation of subsequent tests and improves accuracy. See ‘How Do Breath Tests Work?’ for more information.
The baseline test only needs to be done once and is valid for 12 months.
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Who should and shouldn't have a Hydrogen & Methane Breath Test?
Hydrogen & Methane Breath Tests are useful for the investigation of symptoms which are commonly associated with Irritable Bowel Syndrome or IBS. Carbohydrate intolerance (for example lactose/dairy intolerance) commonly causes all of the symptoms of IBS, including abdominal bloating, cramping, abdominal pain, chronic diarrhoea, nausea, loud stomach-rumbling after meals (“borborygmi”), and excessive belching and/or flatulence.
Small Intestinal Bacterial Overgrowth can cause all of the above symptoms in addition to vitamin deficiencies and malabsoprtion of nutrients (typically causing very smelly stools).
However, carbohydrate intolerance and SIBO do not explain symptoms such as significant weight loss (more than 1 or 2Kg), blood in stools, fevers or diarrhoea lasting less than 1 month. If you are experiencing any of these symptoms, please see your GP or a specialist Gastroenterologist for further investigation.
People with poorly controlled or newly diagnosed Crohn’s Disease affecting the small intestine or Coeliac Disease may possibly have false results on breath testing. If you have persistent symptoms despite good disease control, then HMT may provide an answer for your symptoms and offer a way of managing your symptoms with a diet-based approach.
If you’re unsure, send us a question and our doctors will provide advice on whether HMT is the right test for you.
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What if I have a positive HMT result?
The meaning of a positive result will depend on the type of test you have undertaken. Your test result will include a medical interpretation as well as a plain-language summary so that you can be sure to understand what your test results mean.
However, if you have a positive result we recommend you see your referring healthcare provider, your GP or an Accredited Practising Dietitian for further assistance in understanding the results in the context of your health and to guide you in managing your symptoms in a healthy manner.
It is also important to appreciate that carbohydrate intolerances are common in our community. This means it is possible to have a positive result without the intolerance being the primary cause for your symptoms. In people whose symptoms don’t improve at all with appropriate dietary management after a positive test, we recommend you see your GP or a specialist Gastroenterologist for further investigation and advice.
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What if I have a positive C13 result for Helicobacter pylori?
H. pylori is a common infection of the stomach. It is a chronic infection and is usually acquired in childhood and persists for many decades.
The damage done by H. pylori occurs very slowly and over a long period of time, but is a well-known cause of stomach ulcers and stomach cancer.
A positive test result requires combination treatment with antibiotics and acid medication. Treatment can be difficult and treatment failure is not uncommon, so follow up testing is always recommended.
If you have never received treatment for H. pylori before, you should see your GP for treatment. If you have received treatment before and you are still positive, you should see a specialist Gastroenterologist for advice on treating what is likely a resistant infection.
If there is any history of stomach cancer in your family, you may be referred to a specialist Gastroenterologist for an endoscopy to ensure your stomach is normal.
Once successfully treated, “catching” H. pylori again is very rare.
If you have ever had a positive result, your immediate family should consider being tested. This includes parents, siblings and children.
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What if I have a negative Hydrogen & Methane Breath Test result?
Provided the pretest preparation was followed adequately, a negative result would generally indicate adequate digestion and absorption of the tested sugar. It may be worthwhile testing other sugars.
There are many potential causes for abdominal symptoms, and we consider Hydrogen & Methane Testing a powerful tool in diagnosing carbohydrate intolerance. Comprehensive testing with negative results indicates that sugar intolerance or SIBO is highly unlikely to be the cause of your symptoms.
For a definitive diagnosis in the absence of SIBO and carbohydrate intolerance, we recommend you see a specialist Gastroenterologist.