Chris Kresser: “Under what circumstances do we run Dr. Pimentel’s ibs-smart test?”
We run it in most cases now when people have high hydrogen levels if they’re willing to do it because it can definitely impact the treatment plan and also the risk of recurrence and whether we’re going to use a prokinetic after treatment. Another option would be to just treat first, and then if it recurs, then you could do the ibs-smart test to see if that explains that recurrence, and that’s a way of saving money and sequencing it out a little bit.
Even though the test is not validated for methane-predominant SIBO, we’ll still, at times, run it in patients with methane-predominant SIBO, and we have seen positive results in some of those patients. Remember that the studies are looking at averages, they’re not looking at individuals. On average, it wasn’t validated for methane-[predominant] SIBO, but it doesn’t mean it couldn’t show up in those circumstances, and we’ve definitely seen that come through.