Why SIBO Breath Tests Are Fundamentally Unreliable: And How to Actually Identify What's Happening in Your Gut — Part 3: Putting It Together

By now, you&#8217;ve gathered real data. You likely have SIBO if you have symptoms that appeared 30 to 60 minutes after eating fermentable foods, your transit marker test showed abnormal (too fast or too slow) transit time, your substrate challenge tests provoked severe bloating, gas, or symptoms, your stool is frequently loose, floating, or foul-smelling, your breath smells sulfurous or fermented after eating, your elimination diet led to significant symptom improvement, and your symptoms resolve with gas passage or defecation. This holds even if your breath test was negative. You might have hydrogen sulfide-predominant dysbiosis (usually missed by standard tests) if your breath test was negative or only mildly positive, you have severe neurological symptoms (brain fog, headache, anxiety), sulfur-containing foods trigger the worst symptoms, your stool smells strongly sulfurous, your breath smells sulfurous after meals, you have fatigue, joint pain, or post-exertional malaise, and you have mast cell activation symptoms that worsen with dysbiosis triggers. You might have dysbiosis-driven barrier dysfunction if your primary symptoms are not bloating or gas but rather brain fog, headache, joint pain, or systemic inflammation, you have food sensitivities that developed recently or are worsening, your stool contains mucus regularly, you have skin reactions (rashes, flushing) after e