Commonwealth Diagnostics International

12/18/2025

Unreturned breath test kits don’t just disappear. They turn into delayed answers, extra follow-up, and more friction for your team (and your patients).

New in our Breath Testing Done Right series: “Every Test Matters: The Cost of Missed or Unreturned Breath Test Kits.” It’s a quick read with practical workflow fixes to help improve completion and protect clinical momentum

Read: https://commdx.com/every-test-matters-the-cost-of-missed-or-unreturned-breath-test-kits

Quick poll: What’s the #1 reason kits go unreturned in your world?
A) Patient forgot
B) Prep confusion
C) Return shipping friction
D) Hard to track status

Hydrogen and methane breath testing plays a critical role in diagnosing functional gastrointestinal disorders such as SIBO, IMO, and carbohydrate

12/17/2025

🧪 Picking the right substrate matters.

Glucose: Higher specificity; absorbed proximally—great if you suspect proximal overgrowth or want fewer false positives.

Lactulose: Maps transit across the small bowel—useful for distal overgrowth or when you want to observe early vs late peaks.

When in doubt, start with clinical phenotype (constipation-leaning, post-surgical anatomy, IBS subtype) and choose accordingly—then pivot on a second test if the first conflicts with presentation.

🔗 See how CDI supports both pathways (H₂/CH₄, clinician guides): commdx.com

12/12/2025

Reclaiming the “F-Word” in GI: Functional as a Positive Diagnostic Step
Modern Gastro - with Dr. Anthony Hobson (Functional Gut Clinic)
“Don’t use the word functional.” That’s the advice Dr. Anthony Hobson heard when he founded the Functional Gut Clinic in 2013—because too often, functional had become shorthand for “we don’t know.” He chose the opposite approach.
“I’m reclaiming the F-word. Functional will be the first positive step on the diagnostic pathway.” — Dr. Hobson
Here’s what that looks like in practice:
Functional = Measurable. As a GI physiologist, Dr. Hobson centers the term on what can be quantified—LES competence, esophageal motility, gastric function, and small-bowel fermentation (H₂/CH₄ breath testing).

Functional = Actionable. Findings guide a clear fork in the road: treat the confirmed dysfunction (dietetic interventions, motility support, behavioral therapies, targeted pharmacology) or pivot quickly when function is normal.

Functional = Patient-positive. The label isn’t a dead end; it’s a data-driven starting point that validates symptoms and accelerates next steps.

Why this matters for providers
Sharper phenotyping: Pair hydrogen & methane breath tests with physiology to distinguish SIBO/IMO from reflux phenotypes, rapid transit, or gastroparesis.

Less guess-and-check: A structured functional pathway reduces trial-and-error and improves time-to-treatment.

Aligned standards: CDI’s at-home H₂/CH₄ testing (GC-based, CO₂-corrected, consensus-aligned) integrates cleanly with functional motility and reflux assessments.

Why this matters for patients
Clarity over ambiguity. Functional now means investigated and addressable.

Faster answers, fewer loops. Clearer routing to dietetics, psychology, motility therapy, or pharmacology.

Real-life access. Non-invasive testing that fits into everyday schedules.

🎧 Listen to Episode 5 of the Modern Gastro Podcast to hear how CDI × Functional Gut Clinic are redefining “functional” as a reliable, respectful, and results-oriented pathway.
🔗 Explore CDI’s guideline-aligned hydrogen & methane breath testing: commdx.com

12/10/2025

📊 Dual-peak on lactulose? Here’s how to separate signal from noise.

What the peaks often mean (when prep/timing are correct):

Early rise (typically ≤90 min): Suggests small-bowel fermentation → supportive of SIBO/IMO when criteria are met.

Later rise (>90–180 min): More consistent with colonic fermentation, especially with lactulose’s rapid transit into the colon.

Rule-of-thumb cut points used in practice:

SIBO (H₂): Sustained ≥20 ppm rise within 90 min supports a positive call (consider baseline

12/08/2025

🧠 Myth: A negative breath test means symptoms aren’t gastrointestinal.
✅ Reality: One negative result doesn’t close the case—it refines your next step.

Why a test can be negative (but the problem still GI):

Substrate mismatch: Glucose is more proximal; lactulose surveys the full small bowel. Wrong choice → missed signal.

Timing gaps: Infrequent sampling or ending too soon can miss early/late peaks. (Aim every 15–20 min over ~2.5–3 hrs.)

Different mechanism: Carbohydrate malabsorption (lactose/fructose) can mimic SIBO/IMO but won’t show on a SIBO-only assay.

Motility issues: Slow or fast transit can shift fermentation outside the window, obscuring true positives.

Prep pitfalls: Recent antibiotics, PPIs, probiotics, or diet deviations can dampen or distort curves.

What to do next:

Revisit prep & washouts (ABX/PPI/probiotics).

Consider alternate substrate (glucose ↔ lactulose).

Add lactose/fructose testing when history suggests malabsorption.

Evaluate motility (constipation/diarrhea phenotype, CH₄ trends, pelvic floor, gastric emptying).

Integrate with dietitian/behavioral GI for comprehensive care.

CDI offers dual-gas GC (H₂ + CH₄), CO₂ correction, guideline-aligned intervals, and assay menus (SIBO/IMO + carb malabsorption) so you can ask the right question next.

🔗 Explore testing options and prep checklists: commdx.com

12/05/2025

Advancing GI Diagnostics with Functional Gut Clinic + CDI
Modern Gastro Podcast — featuring Dr. Anthony Hobson
For too long, “functional GI” has been code for: no clear answers—try to cope. In Episode 5 of the Modern Gastro Podcast, CDI CEO Craig S. Strasnick sits down with Dr. Anthony Hobson, founder of the Functional Gut Clinic (FGC) in the UK, to outline a very different future: a structured functional gut pathway that replaces dismissal with diagnostics and action.

What’s new—and why it matters
From vague labels to measurable findings. Instead of “IBS—good luck,” the pathway systematically evaluates LES function, esophageal motility, gastric emptying, and small-bowel fermentation (H₂/CH₄ breath testing) to identify what’s actually off—or confirm when function is normal so care can pivot with confidence.

Partnership at scale. Nearly a decade of CDI × FGC collaboration has expanded access to non-invasive, guideline-aligned testing across the UK, accelerating earlier answers and better triage for patients who’ve bounced between procedures.

Patient-positive framing. A “functional” diagnosis is not a dead end—it’s a data-driven starting point for dietetic interventions, motility support, behavioral therapies, or targeted pharmacology.

Key quote from Dr. Hobson
“We’re turning the field on its head… Welcome to this functional gut pathway—we’re going to sort this out for you.
We’ll show when the LES, esophageal motility, or stomach isn’t functioning properly—or when it is, so we look for another cause.”
What providers gain
Sharper phenotyping: Pair hydrogen & methane breath testing with motility and reflux studies to distinguish SIBO/IMO from rapid transit, reflux-dominant phenotypes, or gastroparesis.

Faster next steps: A clear diagnostic fork—treat the confirmed dysfunction or redirect (e.g., pelvic floor, neuromodulation, dietetics) without losing time on guess-and-check loops.

Aligned protocols: CDI’s at-home H₂/CH₄ testing (GC-based, CO₂-corrected, consensus-aligned) complements FGC’s physiological assessments for a cohesive, multidisciplinary model.

What patients gain
Clarity over conjecture. Fewer dead ends; more targeted plans.

Validation. “Functional” means investigated and addressable, not “in your head.”

Access. Non-invasive testing options that fit real life.

🎧 Listen to Episode 5 of the Modern Gastro Podcast to hear how CDI × FGC are scaling a functional pathway that actually functions—for providers and for patients.
🔗 Learn more about CDI’s guideline-aligned hydrogen & methane breath testing: commdx.com

12/01/2025

⛔️ Lesson from the Lab: When the curve looks flat, don’t stop at “negative.”

A near-flat breath test can mean different things:
-True non-producers (low fermenters)
-Prep issues (recent antibiotics/probiotics, incomplete fast)
-Slow transit shifting gas peaks beyond the window

Pro tip: Pair the curve with clinical context (motility history, meds, substrate used) before ruling out SIBO/IMO. If suspicion remains high, consider the other substrate (glucose ↔ lactulose) or re-test after washout.

🔗 Learn how CDI reports support nuanced interpretation: commdx.com

11/28/2025

🌟 Functional Friday | Small Tools, Big Impact 🌟
Modern Gastro Podcast – Episode 3
ft. Tamara Duker Freuman, MS, RD, CDN
Hosted by Craig S. Strasnick | Powered by Commonwealth Diagnostics International (CDI)
Everyone loves to talk about “miracle” cures. Tamara keeps it honest: real progress in gut health often comes from simple, practical tools used well.
On this episode, she breaks down how powerful the basics can be when they’re evidence-based and personalized:
💬 “There are some really helpful things clinicians can offer that aren’t prescription drugs… and I have no beef with big pharma. I’ll take whatever help is available.”
Instead of pitting approaches against each other, Tamara makes the case for “yes, and…” medicine:
🧰 Tools That Can Be Truly Life-Changing:
✅ A well-chosen fiber supplement – not random fiber, but the right type and dose for the right condition

✅ Targeted FODMAP enzymes – helping patients tolerate more foods and reduce fear around eating

✅ Smart use of meds + nutrition – not either/or, but building layered, realistic plans

She also talks about why she wrote her latest book as “the textbook I never had”—a way to arm fellow clinicians with real-world, evidence-based GI practice gems that don’t live in one neat place anywhere else.
For providers, this is the big takeaway👇
🔎 When you combine:
accurate diagnostics (like CDI’s hydrogen & methane breath testing for SIBO, IMO & carb malabsorption),

accessible tools (fiber, enzymes, OTC supports), and

educated, empowered patients…

…you get care plans that are more effective, more sustainable, and way more human.
🎧 Tune in to Episode 3 of the Modern Gastro Podcast to hear Tamara and Craig talk:
How to use simple tools in a sophisticated way

Why we should stop dismissing OTC options as “too basic”

How better diagnostics + smarter interventions can change a patient’s daily life

👉 Listen now: https://commdx.com
And if you’re looking to build more precise, patient-centered GI care, explore CDI’s at-home breath testing solutions at commdx.com.

11/28/2025

🍁 Happy Thanksgiving from Commonwealth Diagnostics International (CDI) 🍁

Today, we’re especially grateful for the people who make better digestive health possible:

🩺 Providers & care teams who insist on evidence-based medicine and compassionate care

🧪 Lab professionals who protect accuracy at every step

🧍‍♀️ Patients & families who trust us on their path to answers

🤝 Partners across the GI community advancing research, access, and outcomes

Your commitment fuels our mission to deliver Breath Testing Done Right—accurate, accessible diagnostics that help turn uncertainty into clarity.

From all of us at CDI: may your day be full of good food, good company, and zero GI guesswork. 🦃

Learn more about our at-home hydrogen & methane breath tests: commdx.com

11/25/2025

If the test is at home, it can’t be as accurate.

🚫 Myth: At-home breath testing is less accurate than in-clinic testing.

✅ Fact: When done properly, it can be just as rigorous—and far more accessible.

Here’s what makes CDI’s at-home model different:

🧪 Standardized collection protocols aligned with North American Consensus & ACG

⏱️ Guided timing and intervals built directly into kit instructions

🧴 Validated sample stability to protect hydrogen & methane levels in transit

🔗 Required kit registration to eliminate misidentified or “orphaned” samples

🧬 Gas chromatography (GC) analysis in a CLIA-certified lab

The result? Non-invasive, patient-friendly testing that still checks every box for clinical-grade accuracy.

📖 Learn more about how workflow and methodology drive reliable results at commdx.com

11/22/2025

🌡️ “If your whole life is built around your bowels… it’s time to get help.”
🎙️ Functional Friday | Modern Gastro Podcast
Featuring Tamara Duker Freuman, MS, RD, CDN
Hosted by Craig S. Strasnick | Powered by Commonwealth Diagnostics International (CDI)

On this episode of the Modern Gastro Podcast, GI dietitian and author Tamara Duker Freuman gives a simple gut-check for knowing when it’s not “just a little stomach issue” anymore.
She puts it bluntly:
“If your GI function is occupying more than 30 seconds a day of your mindshare…
if you’re waking up hours before work, skipping social events, rearranging your travel, or contorting your life around your bowels…
you should get some help.”
🚩 This is your sign to take symptoms seriously if:
You’re constantly planning life around bathroom access

You avoid travel, dates, or meals because of fear of flares

You wake up early just to “see how your gut is going to behave”

You feel like digestive symptoms run your schedule more than you do

Tamara’s reminder hits hard:
“That’s not normal—and you shouldn’t have to live like that.
There are very, very few people we can’t help improve.
There are solutions for almost every condition.”
For many patients, that path forward starts with better clarity:
Is it really IBS, or is there SIBO/IMO underneath?

Is there carbohydrate malabsorption (lactose, fructose, etc.) making symptoms worse?

Are we missing something that objective testing could reveal?

🔬 Where CDI fits in
Commonwealth Diagnostics International supports this more proactive, patient-centered approach with:
At-home hydrogen & methane breath testing for SIBO, IMO & carb malabsorption

CLIA-certified lab processing & guideline-aligned protocols

Tools that help providers move beyond “wait and see” into targeted, informed care

💬 Big takeaway:
You don’t have to rearrange your life around your bowels.
And as Tamara puts it, even if you can’t get to 100%, you can get to much better.
🎧 Catch the full conversation with Tamara & Craig on Episode 3 of the Modern Gastro Podcast and learn:
When it’s time to escalate from “tolerating” to treating

How diet, diagnostics, and multidisciplinary care work together

Why no one should be dismissed or told to just “live with it”

👉 Listen now at commdx.com

11/19/2025

🔬 Breath Testing Done Right = More Than Just a Kit

At CDI, “Breath Testing Done Right” isn’t a tagline—it’s a checklist:

✔️ Evidence-based timing
• 2.5–3 hour tests
• Samples every 15–20 minutes

✔️ Validated interpretation criteria
• H₂ rise ≥20 ppm within 90 minutes for SIBO
• Methane ≥10 ppm = clinically relevant IMO

✔️ Substrate flexibility
• Glucose and lactulose options to match clinical scenarios

✔️ Robust workflow
• Kit registration to lock in correct patient–sample mapping
• CLIA-certified lab with rapid turnaround

When all of these pieces work together, breath testing stops being “just another test” and becomes a decision-making tool providers can rely on.

👉 Explore how CDI structures every step around accuracy and clinical utility at commdx.com