SIBO - 2 Hour

Test Details

Lab Company: Genova Diagnostics 
Sample Type: Breath 
Collection Location:  At Home

Genova’s 2-hour SIBO Profile measures exhaled hydrogen and methane gases to evaluate bacterial overgrowth of the small intestine.    

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

Key Details 

  • Sample collection should be performed in the morning. It will take 2 hours to complete.
  • You must wait 4 weeks from your last dose of antibiotics, antifungals, antimicrobials, or Pepto-Bismol™ to take this test.
  • You must wait 4 weeks from your last colonoscopy or barium enema to take this test.
  • Avoid using laxatives, stool softeners or bulking agents, and antacids with aluminum or magnesium hydroxide for 7 days prior to testing.
  • A special diet is required for 24 hours prior to testing. 
  • Fasting is required for 12 hours prior to testing.
  • Avoid using toothpaste, smoking, sleeping, and vigorous exercise for at least an hour prior to testing.
  • Ship your samples within 2 days of collection, Monday - Thursday only. 

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Preparation & Timing

  • Do not take this test if you have allergic reactions to lactulose or are on a galactose/lactose-restricted diet.
  • Do not collect during an acute infectious illness. 
  • This test is time-sensitive. Please perform the collection in the morning during an uninterrupted 2 hours.
  • Wait 4 weeks from your last dose of antibiotics, colonoscopy or barium enema.
  • Wait at least 2-4 weeks from your last dose of antifungals, Pepto-Bismol™, or herbal/natural antimicrobial products.
  • Avoid the use of laxatives, stool softeners, and/or stool bulking agents as well as antacids containing aluminum or magnesium hydroxide for 7 days prior to collection.
  • 24 hours before collection, you must follow a special diet.
    • Eat only: Baked or broiled chicken, fish or turkey (salt and pepper only), white bread (only), plain steamed white rice, eggs, clear chicken or beef broth with no vegetable pieces, tofu with salt and pepper, water, plain coffee, or 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.
    • Do NOT take non-essential medications or supplements until you have completed the test (unless told otherwise by your provider).
    • Do NOT chew gum, eat candy, or use mouthwash until the test is completed.
  • 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 (1-6) on the tube labels provided.
    1. You will only use 6 of the 8 tubes provided. Discard the extra 2 tubes.
  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 and the requisition form.
    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. Do not blow hard.
    6. Press the specimen tube into the side part of the mouthpiece. 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 (2-6). 
    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
  9. Pack the tubes in the bubble wrap bags.
  10. Pack the bags and requisition form in the kit box.
  11. 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 (insurance) and here (cash pay).
    • 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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  • Pack the samples using the provided packing materials.
    • Pack the tubes in the bubble wrap bags.
    • Pack the bags and requisition form in the kit box.
    • Pack the box in the provided envelope.
  • 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.
  • Ship samples to the lab within 2 days of collection.
  • Ship only Monday through Thursday. 
  • You can schedule a pickup by calling FedEx at 1-800-463-3339 or visiting

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  • 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

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