Strong human evidence
Lactulose and glucose breath testing for SIBO show poor specificity against jejunal aspirate culture.
Evidence summary
Documented in clinical guidelines and multiple validation studies.
Representative citations
Limitations
Aspirate culture itself has sampling and false-negative limitations; the gold standard is imperfect.
Competing explanation
Breath tests may still have utility for trend monitoring rather than diagnosis.
What would weaken this claim
Improved breath-test methodology with validated specificity against a more reliable gold standard.
Related pages
Educational mechanistic analysis only. Not medical diagnosis or treatment.