Probiotics and gut health: what do you need to know about diagnostics?

The balance of the gut flora (microbiome) is key for digestion and immune function. When this balance is upset, bloating, abdominal pain or bowel movements often occur. Although probiotics can help to restore this, they are not always the first step - especially if the underlying cause is SIBO available.

From Endomedix Gastroenterology Centre summary to help you navigate the world of gut flora disorders and modern diagnostics.

What is SIBO (Contaminated Small Bowel Syndrome)?

SIBO develops when there is an abnormal overgrowth of bacteria in the small intestine (typically migrating back from the large intestine). This can be caused by:

Weakening of defence lines: Low stomach acid (e.g. due to taking a permanent acid reducer).
Motility disorders: Slow bowel movements (in diabetes or hypothyroidism).
Anatomical differences: Adhesions after previous abdominal surgery.

Important: In the case of SIBO, taking probiotics without medical supervision can be risky, as you introduce additional bacteria into an already „overpopulated” section, which can increase bloating.

How can a gut flora disorder be diagnosed?

An accurate diagnosis is essential for targeted treatment. At Endomedix we use the following methods:

1. Hydrogen and methane breath test

This is the most common, painless test for SIBO.

How it works: The patient drinks a special sugar solution. If there is an overgrowth of bacteria in the small intestine, they will ferment the sugar, producing hydrogen or methane gas, which can be measured from the exhaled air.
IMO (Intestinal Methanogen Overgrowth): When methane levels are high, they are often associated with chronic constipation.

2. Laboratory tests

A blood test can help to detect absorption disorders (e.g. low vitamin B12 levels or abnormally high folate levels).

3. Endoscopic examinations

Gastroduodenoscopy and colonoscopy can rule out other diseases that mimic IBS or SIBO (e.g. coeliac disease or inflammatory bowel disease). In our centres, these tests can also available under anaesthesia, ensuring maximum comfort.

When should you see a doctor?

Visit our specialist clinic if you experience any of the following:

Persistent bloating and gas formation.
Sudden abdominal distension after meals.
Unexplained weight loss or vitamin deficiency.
Alternating constipation and diarrhoea.

Once an accurate diagnosis has been made, treatment usually starts with a specific antibiotic, followed by a well-constructed, personalised course of probiotics to stabilise the gut flora once and for all.