Tracey O’Shea: Alright, next one is “I just listened to a lecture by Allison Siebecker. She always orders the three-hour breath test because if she sees a flatline the first two hours without the typical rise of hydrogen in the third hour, then she suspects hydrogen sulfide SIBO. Thoughts?”
So, again, this is just to repeat, this is a question about ordering a three-hour breath test versus the 2.25, I think is kind of what we’re getting at here. The new BioHealth 900-C is the newer version of the SIBO breath test that does 15-minute increments instead of 20[-minute increments] so that you can get a 90-minute value instead of 100, like, you get an 80 and [a] 100, and then you have to kind of average out what that 90-minute value might be, and that can make it a little tricky. I mean, you can pick the plot in coins and try to figure out what the number is between the 80 value and the 100 value, but it’s not perfect. It’s not specific, so I think that is one advantage to using the newer updated criteria SIBO test, but then you might argue that you do lose some of the last little bit of that three-hour test where you may be able to see what the solution is doing, host 135 minutes. So I think there might be some argument for this to do a three-hour breath test. I don’t know that there’s really a disadvantage to doing one over the other, but I would argue that I think even with the 2.25-hour breath test, the 900-C, I think that you would still be able to kind of see this flatline, and then we’re suspecting that the solution is entering the colon at the 90-minute mark and you still have a few more values after that to be able to see if it’s rising. So I think that you probably could still take a look and use the 2.25-hour SIBO test and still get some information about whether you suspect hydrogen sulfide or not. So I don’t have a perfect answer to this [question]. We don’t use the three-hour breath test. We use the newer one. I haven’t really run into this issue because I think that you can still gather enough information with the markers post 90 minutes. The question is if you do suspect after the shorter test, the 2.25-hour test, then you could always repeat a three-hour test or you could treat based off symptoms and suspicion based off the labs that you do have, and then maybe when you do a repeat SIBO test, you could use a three-hour breath test as just kind of a follow-up to double-check, so those are my thoughts. I think it’s reasonable. It makes sense, and I don’t know that there’s really an advantage or a disadvantage to doing the three-hour versus the 2.25[-hour] if you suspect that you might have a hydrogen sulfide case on your hands.