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Passé? Or Something to Consider?

Nowadays, with any mention of digestive symptoms of constipation, diarrhoea, gas, or bloating, and a history of antibiotic or proton-pump inhibitor use, one of the first things most integrative healthcare practitioners will consider in the differential diagnosis list is gastrointestinal dysbiosis with testing for small intestinal bacterial overgrowth (SIBO).[1] SIBO has a lot of hype—and how can it not, with so many conferences, practitioners, and clinics focused on its treatment? Given that the lactulose breath test (LBT), commonly used for the diagnosis of SIBO, has a low sensitivity and frequently gives false-positive results (although sensitivity can be improved via three-hour methane and hydrogen testing), it can be overused for the ease of diagnosing, well, something.[2],[3]

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