An excess of hydrogen sulfide in the gut causes dysbiosis and inflammation, resulting in diarrhea, constipation, bloating and/or fatigue, which are all typical symptoms of those suffering from irritable bowel syndrome (IBS) and small intestinal bacterial overgrowth (SIBO).
However, elevated levels of hydrogen sulfide in the gut are difficult to diagnose and treat due to the limited scientific research and test availability on this gas.
Read our blog, hydrogen sulfide and how it is related to gut health.
At present, in the UK it is not possible to routinely measure hydrogen sulfide for SIBO or IBS via breath testing and caution should be taken if a service refers to a result of a gas that is not measured. However, our latest research is looking promising for the launch of a hydrogen sulfide breath test, watch this space!
So, if a clinician confirms that the levels of hydrogen sulfide in your gut are abnormal, what are the best treatment options for you? One of the most common suggestions would be to follow a low-sulfur diet or avoid sulfuric medications to help reduce the number of hydrogen sulfide-producing bacteria in the gut, but there is a lack of studies that look at this in more detail.
What causes hydrogen sulfide in the breath?
Decreasing the amount of sulfur-rich foods in the diet can be tricky, as sulfur is present in two essential amino acids, methionine and cysteine, in fact, those following a vegan diet or who are elderly, often suffer from low sulfur levels. While the diet is the only source of methionine in humans, cysteine can be produced from methionine via a metabolic pathway (1). Methionine and cysteine play an essential physiological role within the body and a deficiency can contribute to several health issues such as contribute to obesity, heart disease, Alzheimer’s, and chronic fatigue (2). It can also exacerbate a variety of conditions including skin complaints, gastrointestinal concerns, and arthritis (2).
There is plenty of crossover between high-sulfur foods and the FODMAP diet. Examples of high-sulfur foods are eggs, poultry and fish, and allium plants such as garlic, onions, and leeks, as well as cruciferous vegetables like kale, cabbage, and broccoli. Following a low FODMAP is often recommended for those suffering from SIBO and IBS but everyone and their gut microbiome is unique. Therefore, one of the best approaches is to experiment with diet and foods and eliminate different foods for a period to try and determine what triggers your symptoms alongside real-time monitoring of gas production via a breath test. Remember it is best to consult with a dietitian or nutritionist before making drastic changes to your diet.
Therapeutic Strategies and Breath Dynamics
As hydrogen sulfide SIBO is driven by an overgrowth of specialized sulfate-reducing bacteria, it is typically managed using targeted antimicrobials or traditional antibiotics like rifaximin, which help reduce the overall microbial load in the small intestine. While clinical research is ongoing to optimize these specific protocols, another common intervention is bismuth subsalicylate (the active compound found in over-the-counter remedies like Pepto-Bismol).
Bismuth subsalicylate works by actively binding to hydrogen sulfide gas within the intestinal tract, neutralizing its presence and rapidly alleviating acute symptoms. In fact, clinical studies have shown up to a 95% reduction in hydrogen sulfide production in samples after participants consumed bismuth subsalicylate four times daily for three to seven days.
It is important to remember that hydrogen sulfide is just one part of a broader gaseous ecosystem in the gut. Hydrogen and methane are the primary foundational gases produced by your microbiota. Measuring the precise levels of these two gases via breath testing provides a wealth of insight into your upper digestive tract, serving as the clinical gold standard for identifying Small Intestinal Bacterial Overgrowth (SIBO) and Intestinal Methanogen Overgrowth (IMO).
How OMED Health Restores Control
To make these critical diagnostic insights accessible outside of a hospital setting, the medical-grade OMED Health Breath Analyzer precisely measures hydrogen and methane curves from the comfort of home. This technology is exclusively integrated into our clinician-led breath testing kits, distributed and managed entirely through independent healthcare professionals.
By using the companion OMED Health App to seamlessly log your daily meals, sleep quality, and physical symptoms alongside your at-home breath samples, you build a detailed, multi-dimensional data profile. This syncs automatically with your independent practitioner’s specialist dashboard, giving them the exact evidence they need to move away from guesswork and build a targeted, data-driven recovery plan.
References
- Kabil O, Vitvitsky V, Banerjee R. Sulfur as a signaling nutrient through hydrogen sulfide. Annual review of nutrition. 2014 Jul 17;34:171-205. DOI: 10.1146/annurev-nutr-071813-105654.
- Deficiency of sulfur and inability to detox [Internet]. [cited 2023 Aug 3]. Available from: https://www.fammacademy.org/beta/index.php?route=pavblog/blog&id=22
- Suarez FL, Furne JK, Springfield J, Levitt MD. Bismuth subsalicylate markedly decreases hydrogen sulfide release in the human colon. Gastroenterology. 1998 May 1;114(5):923-9. DOI:10.1016/s0016-5085(98)70311-7.
