Why SIBO Breath Tests Are Fundamentally Unreliable: And How to Actually Identify What's Happening in Your Gut — The Bigger Picture

The SIBO breath test became a standard because it was cheap, non-invasive, and objective. These are good things. But they created a false sense of security: the illusion that we could diagnose a complex dysbiotic state with a single three-hour measurement. We can&#8217;t. What you actually have is a dysbiotic ecosystem inside your small intestine with specific dominant microbial species, specific fermentation patterns, specific consequences for your barrier function and systemic health, and a specific relationship to your symptoms. The breath test captures one narrow facet of this reality. It&#8217;s useful information if positive. But a negative result tells you almost nothing, because it was never designed to measure what you&#8217;re actually trying to find out: Is dysbiosis driving your symptoms? You are. By tracking your own physiology, challenging your own microbiota, measuring your own transit time, and evaluating your own response to dietary intervention. You have more data than the breath test could ever give you. And unlike the test, your data directly correlates with what actually matters: whether you improve when you change your gut&#8217;s microbial environment. That&#8217;s not self-diagnosis. That&#8217;s functional diagnosis, the kind that actually predicts treatment response and guides real recovery. Use it. If you&#8217;ve tested negative on a SIBO breath test