Test Details

Lab Company: Gemelli Biotech
Sample Type: Breath
Collection Location: At Home

The trio-smart breath test aids in the identification of small intestinal bacterial overgrowth (SIBO), intestinal methanogenic overgrowth (IMO), and excess hydrogen sulfide.     

🔑 Key Details 📦 Shipping
Preparation & Timing 📊 Results
🧪 Collection Instructions 📚 More Resources
💳 Requisition & Payment
💬 Questions?

Key Details 

  • Save the box your kit comes in. You will need this to ship your sample back to the lab. 
  • If your provider gave you a prescription for lactulose, get it filled prior to sample collection.
  • You must avoid certain medications prior to sample collection. 
  • You must avoid certain foods the day prior to sample collection.
  • You must fast for 8-12 hours prior to sample collection. 
  • Samples must be shipped within 24 hours of collection.

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Preparation & Timing

  • If your provider gave you a prescription for lactulose, get it filled prior to sample collection. 
    • Note: By default, kits come with glucose (which does not need a prescription). 
  • If you are taking antibiotics, consult with your healthcare provider regarding the timing to sample collection. 
    • Some antibiotics should be avoided before sample collection. 
  • Avoid the following medications for at least 7 days prior to sample collection.
    • Promotility drugs
    • Laxatives 
  • You must follow a restricted diet the day prior to sample collection. YOU CAN ONLY EAT AND DRINK THE FOLLOWING ITEMS. 
    • Food
      • Poultry
      • Fish
      • Beef
      • Pork
      • Tofu
      • Eggs
      • White potatoes
      • White rice 
    • Seasonings:
      • Salt
      • Pepper
      • Oil
    • Drinks
      • Water
      • Black coffee (NO ADDITIVES like sugar or milk)
      • Plain tea (NO ADDITIVES like sugar or milk)
  • You must fast for 8-12 hours prior to sample collection. 
    • DO NOT eat or drink anything during this fasting period and sample collection time, except for your glucose or lactulose solution. 
    • You may drink a few sips of water if absolutely necessary.

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Collection Instructions

  1. Ensure you followed the restricted diet and fasting guidelines.
  2. This collection is strictly timed. You MUST follow the collection time exactly. 

    # 1 Drink Substrate # 2 # 3 # 4 # 5 # 6 # 7 # 8 # 9
    9:00 AM 9:00 - 9:05 AM 9:20 AM 9:35 AM 9:50 AM 10:05 AM 10:20 AM 10:35 AM 10:50 AM 11:05 AM
  4. Complete a sticker label with the following information.
    1. Sample number
    2. Sample collection time
    3. Date of collection
    4. Your full name
    5. Your date of birth
  5. Place the sticker label on one of the deflated collection bags.
  6. Attach the mouthpiece to the end of the valve until it fits snugly.
    1. The small hole on the mouthpiece should be facing up.
  7. Turn the cap on the valve counterclockwise until it is fully in the "Open" position.
  8. Take a deep breath.
  9. Exhale continuously into the mouthpiece. 
  10. After 2 seconds, cover the small hole on the mouthpiece with your finger while still exhaling. 
    1. DO NOT inhale. 
    2. DO NOT exhale more than one breath.
  11. Close the cap by turning it clockwise until it is fully in the "Closed" position.
  12. Remove the mouthpiece from your mouth.
  13. Remove the mouthpiece from the valve.
  14. Immediately after collecting your first sample, drink the sugar substrate solution in 5 minutes. 
    1. Glucose substrate
      1. Drink the entire dose of glucose solution provided in your collection kit.
    2. Lactulose substrate.
      1. Drink a single dose of 10gm of lactulose in a 15mL solution with or followed by one cup of water. 
  15. Wait 15 minutes before collecting your next sample. 
  16. Repeat steps 3-12 for each sample collection. Wait 15 minutes in between each sample collection. 
  17. Once you have finished all nine collections, place all filled collection bags into the provided biohazard bag. 
  18. Seal the bag tightly.
  19. Place the biohazard bag and your completed test requisition form into the shipping box.  

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Requisition & Payment

  • Your kit has been prepaid. You DO NOT need to pay anything extra.
  • Instructions on how to fill out your requisition can be found HERE.
    • Since you pre-paid for your tests, you do not need to fill in any payment information on this form.

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  • Samples must be shipped within 24 hours of collection.
  • Ship your samples via UPS.
  • To prepare your samples for shipping,
    • Place all filled sample collection bags into the provided biohazard bag.
    • Seal the biohazard bag tightly.
    • Place the biohazard bag into the trio-smart box.
    • Place the completed requisition form into the trio-smart box. 
    • Place the prepaid return label over the original shipping label.
    • Seal the trio-smart box with packing tape.
  • Make a note of the tracking number on the return label so you can track your samples back to the lab. 

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  • Results should be released to your provider 7 business days after samples are received at the lab. We cannot guarantee processing time. 
  • Your provider will notify you when your results are in and schedule a follow-up appointment for you to review them together. 
  • Your provider may choose to release your results to you. Rupa cannot release your results without provider authorization.

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More Resources

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For general questions, email Rupa Health at For test-specific questions, contact Gemelli Biotech by calling 855-888-1230 or emailing