Procedural Information – Hydrogen/Methane Breath Test

What is a Hydrogen and Methane Breath Test?

A Hydrogen and Methane Breath Test is a painless and non-invasive test which helps to diagnose the following gastrointestinal disorders:
– Lactose Breath Test for lactose intolerance (lactase deficiency)
– Fructose Breath Test for fructose malabsorption
– Glucose Breath Test for small bowel/intestinal bacterial overgrowth
– Lactulose Breath Test for Hydrogen production and intestinal transit time
– Sorbitol Breath Test for Sorbitol malabsorption
– Inulin Breath Test for Fructan intolerance

These tests have been established and accepted for over 30 years and is the preferred test of choice for doctors and patients because they are accurate, non-invasive and safe in children, pregnancy and diabetics.

Why do I need it?

Many patients with functional gut disorders are unaware of the relationship between diet and the gastrointestinal symptoms they present. In particular, patients with chronic symptoms may regard their condition as normal and may not be aware that their symptoms can be effectively managed following a proper diagnosis.

A proper diagnosis is also more accurate than an elimination diet (where the suspected food is removed or reduced from the diet) as it generates quantitative data that can provide an indication of the severity of the disorder, thereby allowing the possibility of retaining certain foods in the diet. Small bowel bacterial overgrowth is treatable with antibiotics.

Can I do this test?

– No antibiotics or probiotic tablets for 2 weeks before the test
– No bowel preparation or colonic irrigation for 2 weeks before the test
– Avoid laxatives, Imodium and codeine if possible 1 day before the test
– Do not stop any prescription medication without discussion with a doctor
– Continue blood‐thinning medications unless instructed otherwise
– Please ask your doctor for advice regarding diabetes medications

How many tests can I do in a day?

Please be advised that only one substrate can be tested per day. You can choose to do the test on site or at your own home. Each test takes up to 2-3 hours.

How do I prepare for the test?

48 Hours before test – PRE-

Breakfast Cereal: Gluten free cornflakes with lactose free milk or rice milk
Eggs with tomato and spinach – Gluten free bread
Morning Tea Fruit – choose from the following only: strawberries, blueberries, raspberries, citrus, pineapple, kiwi fruit
Lunch Plain Rice cakes with hard cheese (cheddar or tasty) and vegemite


Plain Rice crackers with plain canned tuna


Gluten free bread with margarine, lettuce, tomato and hard cheese (cheddar or tasty only)

Salad with lettuce, tomato, cucumber, carrot, capsicum (no dressing)


Fruit (from list below) with lactose free plain yoghurt


Afternoon Tea Fruit – (see above)
Dinner Red meat, chicken, seafood (includes fish, shellfish, plain canned fish) – no marinades, sauces or crumbed meat/fish


Vegetables: potato, pumpkin, carrot, celery, cucumber, lettuce, spinach and tomato


Rice, rice noodles

These items are permitted

Drink: Water (no bubbles or flavour added)

Milk: lactose free milk, rice milk

Tea/coffee: Black tea and coffee, tea or coffee made with lactose free milk

Cereal: Gluten free rice bubbles or gluten free cornflakes

Crackers: Rice cakes, rice crackers, corn chips (plain flavour only)

Grains: Rice, rice noodles, gluten free pasta, quinoa

Spreads/Seasoning: Any oils, Margarine and vegemite, salt and pepper

Protein: Meat (red meat, chicken pork), seafood (fish, shellfish, plain flavoured canned fish), eggs, plain tofu and tempeh.

Nuts: Macadamia, pecan, pine, peanuts and walnuts

Vegetables: Potato, pumpkin, carrot, cucumber, capsicum, lettuce, spinach, tomato, zucchini, celery

Fresh Fruit: bananas, strawberries, blueberries, raspberries, citrus (oranges and mandarins), pineapple, kiwifruit. Cantaloupe

Alcohol: spirits and dry wine – no beer or sweet wine

 INCLUDE:Any types of Sugar, Chewing
gum, all
products, onions, leaks, garlic, cabbage, beans or any pickled vegetables and any type of melon;

Hydrogen/Methane Breath Test Home Kit

Each Hydrogen & Methane Breath Test home kit includes the following:
– Instruction sheet
– Record Sheet
– Pre-labelled breath test bags. There are 6 bags in total for each substrate.
– Substrate
Before you start your breath test, please ensure your have followed the 48 hours diet & fast for 14 hours prior to your test. Only one substrate can be tested per day. Each test takes 2 hours to complete. Please ensure minimal exercise during your test.

Instructions for Take Home Bags

Step 1: Please follow test in order & only 1 substrate can be tested per day to ensure accurate results. Prepare substrate provided as below. DO NOT DRINK IT until you collect breath sample in Bag #1.(refer to step 9)
Test #1 Lactulose – Mix with ½ cup of cold or tap water
Test #2 Lactose – Mix with 1 cup of hot water, then split in half and mix with colder water to make
it easier to drink
Test #3 Fructose – Mix with ½ cup of cold or tap water
Test #4 Sorbitol – Mix with ½ cup of cold or tap water
Test #5 Inulin – Mix with ½ cup of cold or tap water
Test #6 Glucose – Mix with ½ cup of cold or tap water
Step 2: At beginning of the test, remove cap at top end of bag. Keep aside for later use.
Step 3: Take a deep breath & hold your breath for 15 seconds
Step 4: Then start blowing out slowly (not into the bag)
Step 5: When you are about to run out of breath (ie last 5 seconds), blow into the bag
Step 6: Place cap back to seal the bag, record any symptoms you might have.
Step 7: Drink substrate prepared earlier.
Step 8: 15minutes later repeat step 2 to 6 for Bag #2 & Record symptoms
Step 9: 15minutes later repeat step 2 to 6 for Bag #3 & Record symptoms
Step 10: 30minutes later repeat step 2 to 6 for Bag #4 & Record symptoms
Step 11: 30minutes later repeat step 2 to 6 for Bag #5 & Record symptoms
Step 12: 30minutes later repeat step 2 to 6 for Bag #6 & Record symptoms

When testing complete make sure you send bags back as soon as possible and that you have a follow up appointment booked with Dr. Fok to discuss results.