Fermentation in the small intestine
The small intestine is built to absorb, not to host a heavy ferment. When bacteria there break down carbohydrates, gas can build under the ribs within an hour or two of eating. You may look pregnant by evening, belch, or swing between diarrhea and constipation.
That pattern is the concept behind SIBO. It is not a verdict you can make from bloating alone. Dr. Sani Kohen, D.C. and Dr. Tara Kohen, D.C. ask what you ate, how soon symptoms started, and whether an antibiotic, a stomach bug, or abdominal surgery came first.
Lactulose and glucose breath tests in plain language
SIBO breath testing measures gases in your breath after a sugar drink. Lactulose is not absorbed early, so it travels farther down the intestine. A rise can reflect the small bowel, and it can also reflect fermentation once the drink reaches the colon, which is why timing is part of the reading.
Glucose is absorbed higher up, so it mainly challenges the upper small intestine and can miss a problem farther down. Neither sugar is a better test for every person. FRI chooses with you, then reads the graph next to symptoms. A number without a story is not a plan.
A positive test is interpreted with symptoms
A positive breath test in someone who bloats after meals is a different situation from a positive test in someone who feels well. FRI does not treat the printout as the patient. Constipation, diarrhea, and upper abdominal swelling point the plan in different directions.
Stool testing answers a colon question, not this one. The gut health overview explains when GI-MAP is the better first step. If food reactions dominate the history, that is yet another page. Stacking tests without a reason is how people end up confused.
Diet changes stay individual
In Functional Medicine, some people feel better when fermentable carbohydrates are reduced for a while. Others get worse if the diet becomes so narrow that they under-eat. Nutrition and supplementation is built around what you tolerate and what the test showed. There is no herbal antibiotic dose on this page, and no brand protocol.
Functional medicine at FRI does not replace a primary physician, endocrinologist, gastroenterologist, or mental health clinician. Weight loss you did not intend, bleeding, or vomiting needs medical care. A breath test does not rule those out.
What to expect when you are seen for SIBO
You can start with a complimentary 20-minute consultation. The office is out of network, accepts HSA and FSA payment, and provides a superbill. Visits run Monday–Thursday, 9–6.
If a breath test is ordered, you follow a prep diet and a collection schedule. Results are reviewed with your symptom timing. Any food change is revisited, not handed down as a permanent menu.
Using all three pillars without leaving the city
Chiropractic Sports Medicine in this office means assessment plus the tool that fits: adjustment, joint mobilization, Active Release, McKenzie Method, or tape and cups when they serve the plan. Neuromuscular Rehabilitation means DNS, neurodynamics, and corrective exercise after the exam, not a random circuit.
Functional Medicine is for the problems that do not yield to a joint exam alone: thyroid questions, gut symptoms, perimenopause, sleep, and energy. Labs such as DUTCH and GI-MAP are selected from the history. The Mission Viejo chiropractor page is the local hub, and the office page shows the rooms.
What neighbors should know before the first visit
You do not need a referral. Bring prior records if they exist. Red-flag spine symptoms, including new bowel or bladder changes, saddle numbness, or a leg that is rapidly getting weaker, belong in emergency care. We will help you sort ordinary back pain. We will not keep you in the suite if the story is an emergency.
FRI is out of network. Mission Viejo patients use HSA and FSA cards and superbills like everyone else. Drs. Sani and Tara Kohen are both chiropractors. Their training, including Dr. Sani's sports and functional medicine background and Dr. Tara's rehabilitation and imaging background, is on the about page.
Lake loops, youth sports, and the Oso corridor
Mission Viejo's body load is local. The Lake Mission Viejo path is flat and popular, which makes it a useful test: pain that shows up on that loop is not a hill problem. Marguerite Parkway and Olympiad Road are where a lot of the driving and the school traffic actually happen. Saddleback College and the commercial strips along Crown Valley add standing and sitting in the same afternoon. Florence Joyner Olympiad and the sports parks mean a city full of youth sports parents who also sit for work. We ask which of those you did this week.
Because you live here, follow-up is easy to schedule and easy to waste. A plan that depends on you coming in forever is a weak plan. We would rather teach you the movement or the drill that belongs to your actual week, whether that is a lake walk, a desk on La Paz, or a weekend tournament at one of the parks. Lower back pain and neck pain are the complaints we hear most from this pattern.
Finding the suite if you already live in town
26400 La Alameda is on the La Alameda corridor in Mission Viejo, Suite 100. If you are coming from the lake, it is a short cross-town drive, not a freeway project. Parking is at the building. Hours are Monday through Thursday, 9 to 6. People who work in Irvine or Santa Ana and live here often want the first appointment or the last. Say which commute you are protecting. Call (949) 312-1754.
The complimentary 20-minute consultation is available even if you can see the building from your errands. It is a conversation about fit. It is not a treatment and it is not a membership pitch. If you already know you want an evaluation, book that instead so we have time to test movement rather than only talk about it.
Questions patients ask
Which breath test is better, lactulose or glucose?
They look at different stretches of intestine. Lactulose travels farther, so the timing of a gas rise has to be read carefully, including the chance that the colon joined in. Glucose is absorbed sooner, so it speaks more to the upper small intestine and can miss a lower problem. FRI picks from your symptoms. Neither result is read in isolation.
Does a positive test mean I must treat it?
A positive result is interpreted with symptoms. If you bloat, hurt, and change stool pattern in a way that matches the graph, the finding is more useful. If you feel well, FRI will not build an aggressive plan around a number. Your gastroenterologist remains the right clinician for disease of the bowel itself.
Will you give me an herbal antibiotic dose?
No. This page does not list herbal antibiotic doses, and the visit does not copy a protocol from a forum. If antimicrobial support is discussed, it is individualized and coordinated with your physicians. Nutrition changes are similarly specific to you. There is no brand protocol and no promise that gas will be gone in a set number of days.
How is this different from a stool test?
A breath test asks about gases produced after a sugar challenge, which is the SIBO question. GI-MAP stool testing looks at organisms and markers in a stool sample, which is a different compartment. You can read both on the gut health page. FRI does not order them as a pair unless your history asks two questions.
Related care for Mission Viejo
SIBO is handled at the Mission Viejo clinic, not in a satellite office in Mission Viejo. The related pages below stay on that same visit and add the methods or neighboring problems that usually come up in the history.
- Mission Viejo chiropractor
How people from Mission Viejo reach 26400 La Alameda and what the three pillars cover.
- SIBO clinical overview
The non-geographic condition page, if you want the clinic-wide explanation without the drive.
- Functional Medicine
The pillar this problem sits in at Functional Restoration Institute.
- Gut Health in this city
Digestion problems rarely arrive as one tidy symptom. Bloating, stool changes, and food reactions can travel together or take turns. This page.
- Leaky Gut in this city
People say leaky gut when they mean the gut barrier might be letting more through than it should. The plainer name is.
- Food Sensitivities in this city
A food sensitivity panel that looks at IgG or IgA is not an allergy test. Allergy, the IgE kind, is a different.
- Chronic Inflammation in this city
Inflammation is a process your body uses, not a personality and not a mood. It can be useful while you heal and.
- SIBO Breath Testing
A SIBO breath test measures hydrogen and methane in the breath after you drink a substrate, either lactulose or glucose. A rise.
