Breath gases after a measured sugar drink
You give a baseline breath sample, drink a measured amount of lactulose or glucose, and then collect breath at timed intervals. Microbes that ferment the substrate produce hydrogen or methane. Those gases enter the blood and leave in the breath, where the kit measures them. The pattern of the rise, and when it happens, is the result. A single number without a timeline is not the test.
SIBO breath testing takes a few hours of your morning. You do not eat during the collections, and you do not exercise through them. The review visit afterward often runs 30 to 60 minutes depending on the plan. The test itself is the longer, quieter part, done at home with a timer.
Lactulose or glucose, and the day before
Lactulose and glucose are different substrates. Glucose is absorbed earlier in the small intestine, so it may miss a problem farther down. Lactulose travels farther and can be fermented by ordinary colon bacteria if transit is fast, which is one way a graph gets confusing. Dr. Tara Kohen picks the substrate from the question, not from whichever kit is on the shelf.
The day before is a prep diet, plain foods the instructions list, then a fast. The prep exists so leftover fermentable food does not light up the baseline. Skipping the prep is a common reason a graph is unreadable. If you cannot do the diet because of another medical need, say so before you start. A botched prep is worse than a delayed test.
What a rise on the graph means
A rise in hydrogen or methane after the drink means fermentation happened, and the timing suggests where along the gut that fermentation was likely. An early rise is the pattern people mean when they say small intestinal bacterial overgrowth. A late rise can be ordinary colon fermentation, especially with lactulose. Methane is associated, in many people, with slower transit and constipation. Hydrogen is often discussed with looser stools.
SIBO as a label should follow the graph and the symptoms together. Bloating that is clearly tied to meals is part of the story. Brain fog by itself is not a reason to declare overgrowth. GI-MAP stool testing looks at stool organisms and inflammation markers. It does not draw this gas curve. The two tests are allowed to disagree, and the disagreement is discussed rather than averaged.
False positives, and reading with symptoms
False positives happen. A fast transit time can make colon gas look early. A prep that was not followed can raise the baseline. A substrate that does not match the question can overcall or undercall. Dr. Sani Kohen will say when the graph is messy. A messy graph is not rounded up into a treatment just so the test feels worth the fee.
Symptoms decide whether a borderline rise is acted on. A dramatic rise with a matching story is more useful than a small wiggle in someone who feels well. The lab fee is an additional cost, explained before you order, without a fictional price. A free 20-minute consultation can decide if breath testing is the right question. FRI is out of network, accepts HSA and FSA cards, and provides a superbill for the visit.
What a SIBO Breath Testing visit is like
Expect a quiet morning at home with a timer, a drink that may taste plain or slightly sweet, and tubes or a device you breathe into on schedule. The prep diet the day before is part of the test. Set the day aside. Results are reviewed in person so the timing of the rise can be explained on the graph, not in a one-line message.
You should leave the review knowing whether the pattern was early, late, hydrogen, methane, or too messy to use. Next steps, if any, are matched to that pattern and to how you actually feel. A test that does not match the story is allowed to be set aside.
Office facts for a next-door patient
No referral. Bring trail shoes if the foot, knee, or hip is why you came. Imaging is optional unless another doctor already ordered it. Emergency symptoms, especially progressive weakness or bowel and bladder change with back pain, should not be driven to a chiropractic office.
Out of network, superbill, HSA/FSA. Drs. Sani and Tara Kohen see patients on site. Backgrounds are on the about page. The building is on the office page.
Foothill Ranch trails, Portola hills, and Bake Parkway desks
Lake Forest is several towns wearing one name. Foothill Ranch and the Whiting Ranch trailhead mean climbing and descending on dirt. Portola Hills is grades and families. Baker Ranch and the business parks along Bake Parkway mean new housing, sitting, and a short freeway hop. A knee that hurts after Whiting Ranch is not the same case as a neck that hurts after a day in a Bake office. Tell us which Lake Forest you are actually using.
The old El Toro base is now housing and shops, so a lot of daily walking is on new pavement between a car and a desk. That is a fair place to start a gait conversation if the foot or hip is the complaint. Plantar fasciitis shows up in people who added trail miles without adding calf capacity. We will say that plainly if the exam supports it.
The neighbor drive, which people underestimate
Six miles is not zero when El Toro Road is backed up. From Foothill Ranch, El Toro or Portola Parkway toward Mission Viejo is the usual path. From the south side, Trabuco Road. From Baker Ranch, Bake Parkway to local streets. Budget 12 to 20 minutes to 26400 La Alameda, Suite 100, Mission Viejo, CA 92691. Monday through Thursday, 9 to 6. Parking at the suite.
Being close tempts people to squeeze care between school pickup and a trail run. Book the visit when you can stay for the exam. Phone (949) 312-1754. The 20-minute consultation is appropriate if you are comparing this office with a closer high-volume clinic and you want to see the difference before you commit.
Questions patients ask
What is the prep diet for?
It clears fermentable leftovers so the baseline breath is not already high. Skipping it can make the graph impossible to trust. If a medical diet conflicts with the prep, the test waits.
Does a rise always mean SIBO?
No. Timing and the substrate matter, and false positives exist. An early rise plus matching symptoms is a stronger case than a rise by itself.
Why might lactulose and glucose disagree?
They travel different distances in the gut. One can miss a far problem. The other can pick up ordinary colon gas if transit is fast. The choice is part of the interpretation.
Is the breath test included in the visit fee?
No. The kit is an additional cost, discussed before you order. The review visit is separate and often runs 30 to 60 minutes depending on the plan.
Related methods and problems for Lake Forest
SIBO Breath Testing is one tool inside Functional Medicine. It is not booked as a standalone trick disconnected from the exam. These links are the neighboring methods and the problems that most often lead someone from Lake Forest to ask about it.
- SIBO Breath Testing overview
The clinic-wide technique page, without a city attached.
- Lake Forest chiropractor
Drive, neighborhoods, and the rest of the care offered to Lake Forest patients.
- Functional Medicine
The pillar this method belongs to.
- GI-MAP Stool Testing
GI-MAP is a stool test that uses a PCR-style method to ask about microbes, including possible pathogens, and about selected markers of.
- Food Sensitivity Testing
Food sensitivity testing at Functional Restoration Institute looks at IgG and IgA antibodies to foods. It is not an allergy test, and.
- Nutrition & Supplementation
Nutrition at Functional Restoration Institute starts with food. A supplement is added only when a lab or a clear clinical question calls.
- Organic Acids Test
An organic acids test looks at urine metabolites that can reflect gut microbial byproducts, a higher demand for certain nutrients, and signs.
- SIBO in this city
Small intestinal bacterial overgrowth means microbes are fermenting food higher up than they should, which can bring bloating, gas, and stool changes..
