Do I need to have a SIBO test before starting this protocol?

Some people undergo a “SIBO breath test” looking for a SIBO diagnosis, but the breath test is prone to many sources of error.  Within my practice, I stopped using SIBO breath testing on my patients to determine overgrowth because unacceptably high false positive and false negative results made it clinically useless. nnThe “gold standard” test for determining bacterial overgrowth is a procedure that requires a long endoscope to be passed into the small intestine to sample bacteria within the jejunum portion of the small intestine. Then the sample needs to undergo quantitative culturing, DNA identification, and metabolic activation testing of the species in the sample. nnI do not recommend that any of my patients undergo the gold standard test because it is expensive, impractical, is not available outside of a research study, and is unnecessary to improve using The Nemechek Protocol®.