When you see SIBO tested and in a case the patient didn’t follow the prep diet, baseline hydrogen elevated and then drops down before going back up, is the result still valid? Do you need to take anything special in their account while interpreting?

Chris Kresser: Sometimes high baseline hydrogen or methane values can be a sign of SIBO. They’re not always a sign that the patient didn’t prepare adequately. Certainly you would ask the patient and if they say they followed the diet to a T, then that actually could be. That is one of the interpretive criteria for SIBO, although there has been some controversy over that still even with the recent North American consensus statement.