Quality First Quality First

remain intact.
on the box since it is designed to
visit https://www.youtube.com/user/biohealth Please do not staple, tape, or write
the breath collection process,
For a video which explains
return shipping label.
Seal the Pak and affix the
into the UPS Laboratory Pak.
901-C 3. Insert the closed box
SIBO Breath Test (Glucose) transport kit box.
and then place into the
Combo.
Applies to the following tests: for the #910 Lactulose/Glucose clear zippered pouch, seal,
NOTE: Place both pouches into box collection tubes into the
containing your labeled
2. Place the bubble bags
www.ups.com.
(800) 742-5877 or visit box.
Domestic list of UPS locations, call Collection & Transport kit
any UPS location. For a Form into the Specimen
4. Drop the package off at 1. Insert your Patient Submittal
You must ship your samples within 2 days of collection.
Important:
Instructions
Patient Test Ship Monday through Friday
Packing & Return Shipping
Important Information Contents of Your Test Kit
Please read all instructions carefully. CRITICAL instructions are listed
in REQUIRED 24-Hour Preparation Prior to Collecting Samples Tube holder containing 10 Vacuum-sealed
section. sharp needle
Collection tubes
• The EasySampler device tube holder contains a sharp needle.
Do not insert your finger into the tube holder at any time.
The small hole in
• Do not loosen or tamper with the tops of the vacuum-sealed the plastic bag is
collection tubes.
intentional.
• You must ship your samples within 2 days of collection. Ship
Monday through Friday.
• This test will take 2 hr 15 min to complete. A special diet is
required for 24 hours in advance of the collection.
• It is recommended that you practice breathing into the EasySampler™
EasySampler device prior to starting the first collection.
with tube holder
• The small hole in the bag is intentional.
Test Restrictions Patient 10 Patient Glucose (sugar)
• Discontinue the use of any • Avoid enemas for 7 days and Submittal Information packet
probiotics for 4–5 days prior colonics for 2 weeks prior to Form labels
to taking this test. taking this test.
• Discontinue the use of any • Do not smoke for 1 hour prior
antibiotics for 4 weeks to, or during, this test. Packing & Shipping Components
prior to taking this test. • Do not sleep or exercise for 1
However, please talk to your hour prior to, or during, this
doctor before discontinuing test.
antibiotics.
• Do not ingest anything
• Discontinue laxatives besides water during the
[including high-dose ( >2,000 fasting period or during this
mg ) vitamin C or magnesium test.
( >1,000 mg )] for 7 days prior
to taking this test. • Consult with your physician if
you are on a specialty diet or
any medication you feel may Specimen collection & UPS Laboratory Pak and
2 bubble bags
conflict with this test. transport kit return shipping label
 24-Hour Preparation Prior to
Collecting Samples
There are two 12-hour periods of preparation described below.
For example, if you intend to start your breath collections at 8
am, your preparation period starts the day prior at 8 am. From
8 am to 8 pm on the day before collection, you will follow the
limited diet. Later that evening, starting at 8 pm, you will fast
and are only permitted to drink water. You will start collecting
at 8 am the next morning.
FIRST 12 Hours
Sample Collection Steps
The breath samples will be collected at 15-minute intervals
throughout the test period AFTER collection of the BASELINE
sample (Sample #1) and consumption of the glucose
solution.
STEP 1: Prepare the Glucose Solution
1. Find your weight range in the chart below and mix the correct
amount of glucose powder into 8 oz of water.
2. Set aside drink. You will drink this solution AFTER you collect
your baseline sample.
3. DO NOT DRINK THE GLUCOSE SOLUTION YET.

Avoid these foods and beverages: Amount Amount

of Glucose of Glucose

MIXING CHART
Sugar (in any form), fruits and fruit juices, vegetables, Weight Weight
powder into powder into
nuts, seeds, grain products (plain steamed white rice is 8 oz water 8 oz water
permitted), dairy products, alcoholic beverages, beans,
lbs. tbsp. lbs. tbsp.
herbs and spices.
46 - 68 2 115 - 137 5
Permitted and suggested foods: 138 - 164 6
69 - 91 3
Baked or broiled seafood, chicken, turkey, lean beef, crisp 92 - 114 4 165+ Entire Packet
bacon, lean pork, eggs, oils, fats, clear chicken or beef broth,
plain steamed white rice, plain black coffee, tea (avoid green
and herbal tea). STEP 2: Collect the Baseline Sample
1. Hold the EasySampler device in one hand and a collection
LAST 12 Hours tube in the other.
2. Inhale normally (do not take a deep breath), then close your
Discontinue all food and drink except for water. You may mouth around the mouthpiece and exhale normally while
brush your teeth. Perform the Sample Collection Steps keeping the bag inflated. You will only exhale once per each
the next morning. sample collection.
3. At the middle of your exhalation (with bag fully inflated),
Collection Guidelines insert the collection tube for about 2 seconds. Insert and
puncture the tube at mid-exhalation. Hold the tube in place
Collection errors will lead to an inaccurate result on the lab’s for about 2 seconds and then remove it before you finish
instruments and your results may not be usable for analysis. To avoid
your breath. (Do not puncture tube more than once.)
retesting and the associated fees it is VERY important to follow these
precautions. 4. Remove the tube before you finish your exhalation (bag is still
DON’T insert and puncture the tube with the needle prior inflated).
to breathing into the EasySampler™ collection device. 5. Fill out the patient information label and place it on the tube.
Make sure you record the correct Sample # or your results will
DO breathe normally into the collection device and allow the
bag to fully inflate before you puncture the tube with the be inconclusive.
needle.
DON’T take a deep breath and exhale into the device for STEP 3: Collect Samples 2 - 10
sample collection. 1. DRINK the entire glucose solution you prepared in STEP 1
DO inhale normally before exhaling into the collection device. then wait 15 minutes before next collection.
The sample collections must be from a normal breath. Don’t
exaggerate or force your breathing. 2. COLLECT all samples following the Sample Chart below and
Sample Collection Steps in STEP 2. Place each collection tube
DON’T insert and puncture the collection tube at the start into the bubble bag(s) until all samples have been collected.
of the exhalation instead of mid-exhalation.
DO insert and puncture the tube at mid-exhalation. Hold the Sample Collection Time
tube in place for about 2 seconds and then remove it before Baseline Sample 1 BEFORE drinking glucose solution
you finish your breath.
Sample 2 15 minutes after drinking glucose
DON’T puncture the tube more than once.
SAMPLE CHART

Sample 3 30 minutes after drinking glucose

DO take care to puncture the tube with the needle only once.
Sample 4 45 minutes after drinking glucose

BioHealth Laboratory (307) 212-6600 Sample 5 60 minutes after drinking glucose

23900 Hawthorne Blvd Suite 150 (Worldwide) Sample 6 75 minutes after drinking glucose
Torrance, CA 90505 (800) 570-2000 Sample 7 90 minutes after drinking glucose
www.biohealthlab.com (Toll-Free US / Canada)
Sample 8 105 minutes after drinking glucose
For a video which explains Sample 9 120 minutes after drinking glucose
the breath collection process,
visit https://www.youtube.com/user/biohealth Sample 10 135 minutes after drinking glucose