NUH gastroenterologist, Dr Kewin Siah shares about the different investigative tests you have to go through if your doctor suspects you have irritable bowel syndrome (IBS).

Some investigative tests for diagnosis of IBS:
1. Stool samples to check for infections, parasites, and inflammation
2. Blood tests to check for anaemia, inflammation markers, and celiac disease
3. Food and lactose intolerance tests
4. Abdominal imaging, such as ultrasound, CT scan, or MRI, to check for structural abnormalities
5. Colonoscopy or endoscopy to check for any changes in the gut. It is believed that small intestinal bacterial overgrowth (SIBO) and lactose intolerance may be contributing factors in some cases of IBS. Diagnosis of SIBO and lactose intolerance requires specific breath tests

Prepare for the SIBO and lactose breath tests by:
1. Avoid taking antibiotics or undergoing colonoscopy seven days before the breath test
2. Avoid taking probiotics three days before the breath test
3. Avoid taking high fibre or slow digesting foods 12 to 24 hours before the breath test
4. Do not take any food 12 hours before the breath test. Only plain water can be consumed.
5. Two hours before the breath test, please brush your teeth.
6. Do not smoke and avoid breathing in second hand smoke.
7. Do not consume any fluid, chew gum or do vigorous exercises.

Steps for SIBO and lactose breath tests:
- Gurgle with mouthwash for 30 seconds to prevent contamination of the sample by oral flora
- Drink a test drink diluted according to your body weight
- Step 1: Take a normal breath then close mouth around the mouthpiece and exhale smoothly. Continue exhaling into the mouthpiece to keep the bag inflated.
- Step 2: The medical technologist will collect the breath samples in a syringe and analyse using a machine.
- Steps 1 and 2 will be repeated the predetermined time intervals.
- Complete the form given with the sampling times and symptoms.
- Do not drink, eat, sleep or chew gum or candy during this test as it will invalidate the test.

00:00 Introduction
01:00 Do SIBO and lactose intolerance cause IBS?
01:53 How to prepare for the SIBO test?
03:31 How to prepare for the lactose breath test?
04:13 How are the SIBO and lactose breath tests done?

Watch 7 ways to manage symptoms of IBS (Mandarin) at https://youtu.be/reKsbX0zkbM

Watch “Managing IBS Through Diet & Lifestyle” at https://www.youtube.com/watch?v=6HZ-9P1Ormo

Watch “Managing Irritable Bowel Syndrome: Food Triggers and Roles of Dietitian” at
https://www.youtube.com/watch?v=OqegFF71SCM

Learn more about the condition by visiting https://www.nuh.com.sg/Health-Information/Diseases-Conditions/Pages/Irritable-Bowel-Syndrome.aspx

For an appointment with NUH, visit
https://www.nuh.com.sg/patients-visitors/Appointments/Pages/default.aspx

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About National University Hospital (NUH) (Singapore):
NUH is Singapore's major tertiary hospital and referral centre with over 50 medical, surgical and dental specialties. It is the only public hospital in Singapore to offer a comprehensive suite of specialist care for adults, women and children as well as paediatric kidney and liver transplant programme, in addition to kidney, liver and pancreas transplantations for adults.