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.
Chiropractic, rehab, and labs from Tustin
McKenzie Method work is a strong fit when back or neck pain has a direction that makes it better or worse. Corrective exercise is the homework. Adjustments are used when a specific joint is restricted, after the screen that says a thrust is appropriate.
Functional medicine visits cover thyroid, sleep, and gut health when those are the actual complaint. The Tustin chiropractor page collects the local routes into the three pillars.
Fees, referrals, and the doctors
Out of network. Superbill. HSA and FSA. No referral required. We will not change a prescription from your physician. Emergency symptoms, including sudden neurologic loss, go to the ER rather than to La Alameda.
Drs. Sani and Tara Kohen practice at FRI. Their backgrounds are on the about page. The suite and gym are on the office page.
Old Town, the Legacy, and the North Tustin hills
Tustin has three different weeks. Old Town is walkable, with short blocks and a lot of sitting in cafes and small offices. Tustin Legacy, on the old base, is wide, new, and built around a car. North Tustin and the hills toward Foothill are grades, older homes, and a drive down to the 55. A low back from Legacy commuting is not a knee from a North Tustin hill. We ask which one you live in before we guess at a load.
The District and the shopping around the Legacy add standing errands on top of desk jobs. Neck pain and headaches often belong to the screen. Knee pain and hip pain show up when hill residents add steps without a plan. Plantar fasciitis shows up in people whose walking is almost all concrete between the car and a door.
South on the 55
The 55 south to the 73 is the usual path to La Alameda. About 16 miles. Twenty-five minutes is a good day. Forty is a 55 that is not cooperating. Address: 26400 La Alameda, Suite 100, Mission Viejo, CA 92691. Parking at the building. Monday through Thursday, 9 to 6.
Do not book the visit as a gap between school pickup in Old Town and a meeting. The exam needs you present, not halfway back on the freeway in your head. Call (949) 312-1754. A complimentary 20-minute consultation is available if you want to meet the doctors before an evaluation.
Extra context on SIBO
On the days before a consult, write what you ate and the minute bloating started. An hour after fruit is a different clue than midnight discomfort after a large late dinner. Note prior antibiotics, food poisoning, and any abdominal surgery, because those details change how a breath test is valued. If constipation is the main issue, say whether gas is trapped or whether you simply do not go. Those are not the same mechanism. Bring old breath tests too, including ones that were called borderline, so the new graph is compared with the old one rather than treated as a first look.
Food changes work when they are narrow enough to teach you something and wide enough that you can live. A week of careful notes beats a month of a diet you resent. If a reduction in fermentable foods helps, FRI still plans the return of foods, not a permanent short menu. Supplements, if any, are discussed one at a time. Chiropractic Sports Medicine and Neuromuscular Rehabilitation do not treat overgrowth, but they matter if back or rib pain is changing how you breathe and eat. A breath test is reread with symptoms, not treated as a score you must beat.
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 Tustin
SIBO is handled at the Mission Viejo clinic, not in a satellite office in Tustin. The related pages below stay on that same visit and add the methods or neighboring problems that usually come up in the history.
- Tustin chiropractor
How people from Tustin 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.
