Taking the Hydrogen Breath Test

Summary

Dr. Jasmine Zia and Brian Donahue from UW Medicine explain the hydrogen breath test for detecting small intestinal bacterial overgrowth. The video covers the test kit's contents, preparation with dietary and medication restrictions, and the step-by-step process of collecting breath samples over three hours. They demonstrate the technique for capturing samples, emphasize the importance of labeling them accurately, and advise on mailing the samples back promptly for analysis, with results expected within one to two weeks.

Takeaways

• 🧑‍⚕️ The hydrogen breath test is conducted to detect small intestinal bacterial overgrowth (SIBO), which can cause symptoms like abdominal pain, bloating, diarrhea, and constipation.
• 🔍 The test involves collecting breath samples using a specific apparatus and technique, which includes a mouthpiece and vials.
• 📦 The test kit contains instructions, test vials, a mouthpiece, a practice tube, labels for the vials, lactulose (the sugar substrate for testing), bubble wraps, and a mailing label.
• 🍽️ Dietary and medication restrictions must be followed a month before the test to avoid altering gut bacteria composition.
• 🚫 On the day before the test, a very restrictive diet is required, with no butter, oil, sweeteners, or creamer, and only salt and pepper for seasoning.
• 🕒 The test day involves no mouthwash, smoking, eating, chewing gum, or consuming breath mints or candy for at least one hour before starting and no sleeping or exercising during the test.
• 🗓️ The test takes place over three hours, with 10 breath samples collected on a 20-minute cycle, starting with a baseline sample before consuming lactulose.
• 💨 To capture a breath sample, inhale normally, exhale into the mouthpiece, and then quickly insert the test tube into the vial, pressing for a count of one thousand, then release.
• 📝 It's important to label each vial immediately after collecting a sample, noting the sample number, date, time, and patient's name.
• 📦 After completing the test, place the vials in bubble wraps for protection and use the provided mailing label to send them back to the clinic.
• ⏰ The samples should be mailed back as soon as possible, ideally within one to three days after the test.
• 📞 Patients can expect to receive their results within one to two weeks, either by mail, email, or a phone call.

Q & A

What is the purpose of the hydrogen breath test?

The hydrogen breath test helps detect the presence of small intestinal bacterial overgrowth (SIBO), which can cause symptoms like abdominal pain, bloating, diarrhea, and constipation.

What items are included in the hydrogen breath test kit?

The kit includes instructions, two packets of test vials, a mouthpiece, a practice tube, ten labels, lactulose (a sugar substrate), two bubble wraps for the vials, and a mailing label.

Why is it important to follow the dietary and medication restrictions before the test?

Following the dietary and medication restrictions is crucial because these factors can alter the makeup of gut bacteria, potentially affecting the test results.

What are the specific dietary restrictions on the day before the test?

On the day before the test, the diet is very narrow. Food should only be spiced with salt and pepper, with no butter, oil products, sweeteners, or creamer allowed.

What are the guidelines for test day preparation?

On test day, brush your teeth at least two hours before starting, avoid mouthwash, and refrain from exposure to cigarettes for at least one hour. Do not eat food, chew gum, or use breath mints or candy during the test.

How is the test conducted, and what is the timing for taking breath samples?

The test involves collecting 10 breath samples over three hours. Start with a baseline sample, then drink the lactulose. Take subsequent breath samples every 20 minutes until all vials are filled.

How should patients use the mouthpiece and vial to collect a breath sample?

To collect a breath sample, take a normal breath in, wrap your mouth around the mouthpiece, and blow out. Then, insert the vial into the mouthpiece, press it in, and count to two seconds before releasing it.

Why is it important to label each vial immediately after collecting a breath sample?

Labeling each vial immediately is crucial because the sequence of the breath samples is essential for accurate test results.

How should the vials be prepared for mailing after completing the test?

After completing the test, place the vials in bubble wraps to protect them during transit. Attach the provided mailing label to the box and send it back as soon as possible, preferably within three days.

How long does it take to receive the test results, and how will they be communicated?

Test results typically take one to two weeks to be processed. Patients may receive their results via mail, email, or a phone call.

Outlines

00:00

🧪 Hydrogen Breath Test Introduction and Kit Overview

Dr. Brian Donahue and Dr. Jasmine Zia from UW Medicine introduce the hydrogen breath test, which is used to detect small intestinal bacterial overgrowth (SIBO). They explain the symptoms associated with SIBO and demonstrate the contents of the test kit, including instructions, test vials, a mouthpiece, a practice tube, labels, lactulose (the sugar substrate), bubble wraps, and a mailing label. The doctors emphasize the importance of following dietary and medication restrictions before the test to ensure accurate results.

05:00

📝 Preparation and Procedure for the Hydrogen Breath Test

This section outlines the preparation and timing for the hydrogen breath test. Patients are advised to follow dietary restrictions a month before the test and a very specific diet the day before. On the test day, they should avoid mouthwash, cigarettes, food, gum, and exercise during the test period. The test involves collecting 10 breath samples over three hours, starting with a baseline sample before consuming lactulose. The doctors suggest a testing window and a 20-minute cycle for sample collection. They also demonstrate how to use the mouthpiece and vial to capture breath samples correctly.

🔖 Labeling and Submission of Breath Test Samples

After completing the breath samples, patients are instructed to label each test vial with the sample number, date, time, and their name. This is crucial for the sequence and accuracy of the test results. Once all samples are collected and labeled, they should be placed in bubble wraps for protection and mailed back to the clinic using the provided mailing label. The doctors recommend mailing the samples as soon as possible, ideally within one to three days after the test.

📨 Receiving Test Results and Follow-up

Patients can expect to receive their hydrogen breath test results within one to two weeks. The results will be communicated via mail, email, or a phone call. The doctors advise that following the preparation instructions and technique carefully will lead to a successful test, aiding the gastroenterologist in better understanding the patient's health. If patients have any questions regarding the test or their medications, they are encouraged to call the provided number.

Keywords

💡Hydrogen Breath Test

The Hydrogen Breath Test is a diagnostic procedure used to detect the presence of small intestinal bacterial overgrowth (SIBO). It involves measuring the hydrogen gas in a person's breath after consuming a substrate, like lactulose, which is metabolized by bacteria. In the script, it is described as a 'tricky little test' that requires a specific apparatus and technique to administer correctly. The test helps in identifying symptoms such as abdominal pain, bloating, diarrhea, and constipation, which can be indicative of SIBO.

💡Small Intestinal Bacterial Overgrowth (SIBO)

Small Intestinal Bacterial Overgrowth refers to a condition where an excessive amount of bacteria grows in the small intestine, which can lead to various gastrointestinal symptoms. The term is central to the video's theme as the hydrogen breath test is used to detect this condition. In the script, it is mentioned as the reason for conducting the breath test to identify symptoms such as abdominal pain and bloating.

💡Lactulose

Lactulose is a synthetic sugar that is used as a substrate in the hydrogen breath test. It is not absorbed by the body and reaches the colon, where it is fermented by bacteria to produce hydrogen gas. The script mentions lactulose as the 'sugar substrate that we use to test the breath,' which is consumed by the patient after providing a baseline breath sample.

💡Mouthpiece

The mouthpiece is a component of the apparatus used in the hydrogen breath test to collect the patient's breath sample. It is essential for the correct administration of the test. In the script, it is described as having a place for the patient's mouth and a place to insert the test tube to capture the breath sample.

💡Practice Tube

The practice tube is a part of the breath test kit that allows patients to practice the technique of collecting their breath sample before the actual test. It is not used for collecting samples but helps familiarize patients with the process. The script mentions it as an item in the kit that helps patients 'practice collecting our breath.'

💡Diet Restrictions

Diet restrictions are guidelines provided to patients before taking the hydrogen breath test to ensure accurate results. They involve avoiding certain foods and substances that could affect the gut bacteria composition. The script emphasizes the importance of adhering to these restrictions, especially the day before the test, by avoiding butter, oil products, sweeteners, and creamer.

💡Baseline Breath Sample

A baseline breath sample is the initial breath sample collected before the patient consumes the lactulose during the hydrogen breath test. It serves as a reference point to compare with subsequent samples. The script instructs the patient to take the baseline sample 'just before noon' before drinking the lactulose.

💡Vials

Vials are small containers used to collect and store the breath samples during the hydrogen breath test. Each vial represents a specific time point in the test. The script describes the vials as part of the kit, with a set of 10 vials for collecting the breath samples over a span of three hours.

💡Labeling

Labeling in the context of the hydrogen breath test refers to the process of marking each vial with specific information, such as the sample number, date, time, and patient's name. This is crucial for the sequence and identification of the breath samples. The script emphasizes the importance of labeling 'as you go' to ensure the correct order and information is recorded.

💡Mailing Label

A mailing label is a pre-addressed label provided in the test kit for patients to return their completed breath test samples to the clinic. It is an essential part of the process to ensure the samples reach the testing facility. The script mentions the mailing label as an item at the 'very bottom of the box' and instructs patients to use it for returning the samples.

💡Test Results

Test results in the context of the hydrogen breath test refer to the analysis of the collected breath samples to determine the presence of SIBO. The script indicates that patients can expect to receive their results within one to two weeks, which will be communicated through a letter, email, or a phone call.

Highlights

Introduction to the hydrogen breath test by Dr. Jasmine Zia and Brian Donahue from UW Medicine.

The hydrogen breath test is used to detect small intestinal bacterial overgrowth.

Symptoms of small intestinal bacterial overgrowth include abdominal pain, bloating, diarrhea, and constipation.

Unboxing the breath test kit and its contents, including instructions, test vials, mouthpiece, and lactulose.

Explanation of the dietary and medication restrictions prior to the test for accurate results.

Detailed instructions for the day before the test, including a specific diet and restrictions on food additives.

Test day preparation includes no mouthwash, cigarettes, food, gum, or exercise during the test period.

The test involves collecting 10 breath samples over three hours with a 20-minute cycle.

Demonstration of how to use the mouthpiece and vial to capture breath samples.

Instructions on labeling each vial with the sample number, date, time, and patient's name.

Importance of mailing the test samples back to the clinic as soon as possible, ideally within three days.

Patients can expect to receive their test results within one to two weeks.

Results will be communicated to the patient via letter, email, or a phone call.

The hydrogen breath test helps gastroenterologists understand patients' health better.

Encouragement for patients to follow the preparation and technique instructions carefully for a successful test.

Contact information provided for patients with questions about the test or current medications.

Transcripts

hi i'm brian donahue with uw medicine

and this is dr jasmine zia a board

certified gastroenterologist with uw

medicine's digestive health center

we are here to explain

the uh prep and self-administration of

the

hydrogen breath test

this is a tricky little test in that it

involves an apparatus that you've

probably never seen before and the

technique is very specific but before we

get to that would you explain the

usefulness of the breath test what does

it tell you

sure so the hydrogen breath test helps

us detect whether there's any presence

of small intestinal bacterial overgrowth

so we're accustomed to of course have

bacteria in our digestive system but

more so in the colon so when it

is present in the small intestine then

that's when you can get symptoms such as

abdominal pain bloating diarrhea and

even constipation

okay

so i'm going to step away for a moment

while you explain the items that come in

the kit that the patients receive

so the breath test comes in the

following box

and so i'm going to show you what's

inside the box so the first thing you're

going to see

is a set of instructions there should be

two pieces of paper in there

the next thing you should have are two

packets of vials and these are the test

vials that your breath sample will go

inside

next this is the mouthpiece which we'll

show you more closely later next you'll

find a practice tube and this one isn't

actually going to

collect any of the samples we'll test

but it helps us practice collecting our

breath

then there should be 10 labels

for the vial

then of course the lactulose which is

the sugar substrate that we use to test

the breath

and then there should be two bubble

wraps to put the vials inside

and finally at the very bottom there

should be a mailing label to return the

box

and now here's information about the

preparation and timing of the test

in the month before your test pay close

attention to the dietary and medication

restrictions that you received from the

clinic

these restrict food and other items that

would change the makeup of your gut

bacteria

on the day before your test please

adhere to the diet below yes it's

extremely narrow but it's just one day

you can do this

be sure to spice food only with salt and

pepper no butter or oil products and no

sweeteners or creamer

okay it's test day

brush your teeth at least two hours

before you start no mouthwash

no exposure to cigarettes for at least

one hour before starting

no food gum breath mints or candy during

the test do not sleep or exercise during

the three hours of the test

the test itself involves collecting 10

breath samples over a span of three

hours

here's an approach that might work for

you

start the test just before the hour

whatever hour you choose

say you've blocked out noon to 3 pm for

the test

just before noon use the first vial for

your baseline breath sample

immediately afterward mix and drink the

lactolose

remember baseline sample first

then the lactalos

at 12 20 take your second breath sample

then you're on a 20-minute cycle

repeating the test until all the vials

are filled

i'm back and i'm here to help dr zia

demonstrate the breath test how to

capture a sample with a vial and the

mouthpiece so here's the

the mouthpiece and

it has a place where you put your mouth

and then it has the place where you put

the

the test tube to capture your sample

this is this is not the one of the

actual samples of the practice test

right that's correct we put it in there

so you guys can practice before we

actually start collecting our samples so

what do i do i'm yeah so let me walk you

through it so essentially what you're

going to do is you're going to take a

normal breath in and you're going to

wrap your mouth around the mouthpiece

and blow out one one thousand to one

thousand there are vents in there and so

that's okay and then once you do that

you're gonna push the vial in and press

one one thousand two one thousand

release the vial and then you can stop

breathing and sometimes that happens but

that's okay you can actually go ahead

and

bring this up some of you might do this

yeah and so that's the one thing is to

make sure when you push the vial in that

you push it in and you make sure to pull

it from the actual plastic okay let me

try that again portion because i mean we

could put another breath in here this is

a self-sealing tube too yes and then

this is also the practice this is the

practice tube okay so let's do it one

more time so

normal breath in take a normal breath in

breathe out one one thousand two one

thousand then you're gonna insert the

tube into the vial

and press one one thousand two one

thousand pull that out

and then there's your sample

okay i can tell that my breath is in

there

let's say that

a patient has practiced this and they

feel familiar with it and they've

actually completed the first

the first real sample

filled the first test vial and now it's

time to label it you you would prefer

that patient's label as you go correct

yes it's very important um and so

you want that labeling yeah you want to

label as you go because it's very

important for this test for us to know

the sequence of those breath samples

so these are the labels that it comes in

with and so important thing that we need

filled out on this is the sample number

which one this is

and then it's important to write the

date and time to write your name and

then it's not necessary to fill out the

rest but if you want to it's optional

you can actually write if you're having

any symptoms during the test

say we have completed the all the all

the vials

we filled our

breath samples into the

ten test tubes and labeled them

correctly what about

what about mailing

how do patients get the test back to the

clinic yeah

so

as mentioned beforehand at the very

bottom of the box

there's two items that's important with

mailing it's important for you to stick

all of the test vials

into these bubble wraps to make sure

that they don't get injured on the

travel over to us

and then there's also

a mailing label

and so what you just need to do is to

unpeel the sticker there and stick it at

the top here and mail it back to us

how soon

after the test happens does the patient

need to

get the samples back to you if they take

the test on a saturday can it be can

they send that sample back on monday is

that okay yeah i would really say to

mail it back as soon as you possibly can

but i definitely wouldn't extend it past

a week so really trying to get in that

mail by by

the next day or within the next three

days would be great

and what about

hearing back how soon can patients

expect to hear their results back and

and do the results come in a phone call

or email or will they have to make a

follow-up appointment

yeah so you should expect to get the

results back anytime from one to two

weeks

and typically we will actually send you

either a letter by mail or email um or

we'll give you a phone call so if you

carefully follow the instructions about

the preparation and the technique you

should have a successful test and help

your gastroenterologist

understand your health better good luck

thank you

if you have any questions about the test

or about medications you're currently

prescribed please call the number below