SIBO - 3 Hour

Preparation & Timing

• This test is time-sensitive. Please perform the collection in the morning during an uninterrupted 3 hours.
• Do not take this test if:
  • You have allergic reactions to lactulose.
  • You are on a galactose/lactose-restricted diet.
  • You have an acute infectious illness. 
• Collect your sample 4 weeks after: 
  • Your last dose of antibiotics
  • A colonoscopy
  • A barium enema
• Collect your sample at least 2-4 weeks after:
  • Your last dose of antifungals
  • Taking Pepto-Bismol™
  • Taking herbal/natural antimicrobial products
• Avoid using the following medications for 7 days prior to collection: 
  • Laxatives
  • Stool softeners
  • Stool bulking agents 
  • Antacids containing aluminum or magnesium hydroxide
• 24 hours before collection, you must follow a SPECIAL DIET.
  • YOU MAY ONLY EAT THE FOLLOWING FOODS: 
    • Baked or broiled chicken (salt and pepper only)
    • Baked or broiled fish (salt and pepper only)
    • Baked or broiled turkey (salt and pepper only)
    • White bread (only)
    • Plain steamed white rice
    • Eggs
    • Clear chicken broth with no vegetable pieces
    • Clear beef broth with no vegetable pieces
    • Tofu with salt and pepper
    • Water
    • Plain coffee (no sugar/artificial sweeteners or cream)
    • Tea (no sugar/artificial sweeteners or cream) 
  • DO NOT take probiotics.
• Fast for 12 hours prior to the test. 
  • DO NOT eat or drink anything other than water.
• Avoid the following for 12 hours prior to and during collection:
  • Non-essential medications or supplements until you have completed the test 
    • Do not discontinue prescription medications without consulting your healthcare provider. 
  • Chewing gum
  • Eating candy
  • Using mouthwash
• At least one hour prior to and during collection,
  • DO NOT smoke or inhale second-hand smoke.
  • DO NOT sleep or participate in vigorous exercise.
  • DO NOT use toothpaste.

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Collection Instructions

1. Write your name and the tube number (1-8) on the tube labels provided.
   1. Please ensure that the name on the label matches the name on your requisition EXACTLY. If it does not match, you may need to recollect your samples.
2. Stir the lactulose solution into 8 ounces of water.
3. Set the lactulose solution aside. Do NOT drink yet.
4. Brush your teeth and tongue without using toothpaste or mouthwash.
5. Rinse your mouth with water.
6. Collection:
   1. Take the first collection tube and apply the label. 
   2. Record the time and date of collection on the label.
   3. Pick up the mouthpiece/plastic bag in one hand and Tube 1 in the other.
   4. Breathe normally. Inhale and hold for 5 seconds.
   5. Close your mouth tightly around the mouthpiece and exhale normally into the plastic bag until it fills completely. 
      1. DO NOT blow hard.
   6. Press the specimen tube into the side part of the mouthpiece. 
      1. DO NOT inhale.
   7. Remove the tube within 2 seconds of puncturing. 
   8. Stop exhaling into the mouthpiece. 
   9. Place the tube in the bubble wrap bag. DO NOT unscrew the cap on the collection tube. 
7. Drink the lactulose solution immediately. 
   1. Drink the entire amount within 5 minutes.
   2. DO NOT drink water for 1 hour after you drink the solution. 
8. Repeat the steps under “6. Collection” for each breath collection, following the schedule below. Use the remaining tubes in order (2-8). 

   Tube Number	Wait Time After Previous Tube
   2	20 minutes (from drinking solution)
   3	20 minutes
   4	20 minutes
   5	30 minutes
   6	30 minutes
   7	30 minutes
   8	30 minutes

9. Pack the tubes in the bubble wrap bags.
10. Complete the test registration (instructions HERE).
    1. Please ensure that the name on the registration matches the name on your Rupa order EXACTLY. If it does not match, you may need to recollect your samples.
11. Pack the bags and completed activation card in the kit box.
12. Pack the box in the provided, prepaid FedEx mailer.

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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 the payment information on any of these forms.

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Shipping

• Ship samples to the lab within 2 days of collection.
• Rupa Health recommends shipping Monday - Thursday only to avoid shipment delays.
• To prepare your samples for shipping,
  • Place the sample tubes into the bubble wrap bags.
  • Place the bubble wrap bags into the test kit box.
  • Place the completed activation card into the test kit box.
  • Place the test kit box into the provided return envelope.
  • Seal the return envelope.
• Make a note of the tracking number on the envelope so that you can track your sample back to the lab. 
• Ship samples using the provided, prepaid FedEx mailer. 
  • More shipping information can be found HERE, as well as in the insert included with your kit.
  • You can schedule a pickup by calling FedEx at 1-800-463-3339 or visiting www.fedex.com. 
  • DO NOT place your samples in a FedEx drop box.

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Results

• Results should be released to your provider 7-10 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

• Test Information
  • SIBO Info Page
  • Patient Brochure
• Other Information
  • Genova Patient Info Page
  • Genova Patient FAQ
• Collection Instructions
  • [PDF] How to Collect Your Sample
  • [VIDEO] How to Collect Your Sample

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Questions?

For general questions, email Rupa Health at support@rupahealth.com. For test-specific questions, contact Genova Diagnostics by calling 1-800-522-4762 or chatting with support.