Commonwealth Diagnostics International

Commonwealth Diagnostics International CDI offers products and services that aid the diagnosis of small intestinal bacterial overgrowth (SIBO) and irritable bowel syndrome (IBS).

Founded in 2015 in Salem, Mass., and operating out of its CLIA-certified laboratory and as an FDA-registered, ISO 13485-certified medical device manufacturer, Commonwealth Diagnostics International (CDI) helps providers identify and diagnose common sources of digestive distress and functional gastrointestinal ailments. CDI’s expansive portfolio of non-invasive at-home hydrogen and methane breath tests supports the diagnosis and treatment of Small Intestinal Bacterial Overgrowth (SIBO) and Intestinal Methanogen Overgrowth (IMO), as well as fructose malabsorption, lactose malabsorption, and sucrose malabsorption. Focused on patient-centric principles, CDI breath tests are easy-to-use, quick, and safe for patients and support meaningful GI health outcomes by helping steer each practitioner’s approach to dietary modification, homeopathic remedies, nutritional supplementation, immune support, high-quality probiotics, and additional testing.

Every unreturned kit is a missed diagnostic opportunity — not just a logistical gap.Across CDI's network, practices achi...
03/18/2026

Every unreturned kit is a missed diagnostic opportunity — not just a logistical gap.

Across CDI's network, practices achieving return ratios consistently above 70% share one common workflow: they register kits at the point of distribution. Registration transforms a passive test into an actively supported diagnostic process. When a kit is unregistered, that patient has no reminders, no follow-up, and no accountability — and your chart stays incomplete.

What changes when visibility improves:
Registered kits trigger automated email and SMS reminders to patients, reducing the follow-up burden on your team.​
MyGI Gateway shows registered vs. unregistered kits, tests in progress, and completed results — all in one view, so gaps are visible before they become missing data.​
Practices with consistent kit registration see more actionable results, faster patient follow-up, and greater operational efficiency without adding staff workload.​

How CDI supports return ratio improvement:
Real-time MyGI Gateway tracking → full test lifecycle visibility from order to result.
Automated patient reminders via email and SMS → higher completion without practice follow-up.​
Provider Relations team → available to review your metrics and optimize workflows for your staff and patient population.​

Strong return ratios start with one step at the point of distribution. See how MyGI Gateway gives your practice that visibility →
https://commdx.com/mygigateway/



Single Tweet

Every unreturned kit is a missed diagnostic opportunity. Kit registration at the point of distribution is what separates practices with 70%+ return ratios from those chasing missing results.
commdx.com/mygigateway/

When patients describe at-home breath testing as easier to use than any other medical kit they have received, that direc...
03/17/2026

When patients describe at-home breath testing as easier to use than any other medical kit they have received, that directly affects how likely they are to complete it — and how confidently your staff can hand it off.

Here is what one CDI patient shared recently:

"They kept me informed of when the kit would be sent to me, when it was received, and sent the results in a timely manner. The instructions were extremely easy to understand. I have had other medical kits mailed to me and none of them were anywhere near as easy to use as this one."

— Kay Beaulieu

When patients feel informed and supported at every step, completion rates improve — and you get the diagnostic data you need without chasing kits or fielding preparation questions.

How CDI supports that experience:

Step-by-step prep instructions included with every kit → patients know exactly what to do before they open the box.​
Real-time shipping and status updates → patients stay informed from dispatch through results, reducing inbound calls to your practice.
Pre-paid return shipping included → no coordination required from your staff after distribution.

If you would like to see the materials patients receive from CDI, reach out to our team to walk you through the full experience.

When a patient presents with bloating, constipation, and diarrhea — sometimes all three in rotation — the symptom pictur...
03/13/2026

When a patient presents with bloating, constipation, and diarrhea — sometimes all three in rotation — the symptom picture alone will not tell you which gas is driving it.

According to ACG Clinical Guidelines and the North American Consensus on Breath Testing, three validated trace gases impact GI function: hydrogen, methane, and carbon dioxide.

Elevated hydrogen is associated with diarrhea and abdominal discomfort. Elevated methane is associated with constipation. Symptoms overlap significantly with other functional GI disorders, making objective measurement the only reliable differentiator.

What changes in your workup:

•Use hydrogen and methane breath testing to identify which gas pattern is driving the clinical picture before defaulting to a symptom-based diagnosis.
•Treat CO₂ measurement as a calibration variable. Appropriate levels support gut health; elevated levels contribute to bloating and distension.
•Note that hydrogen sulfide (H₂S) research is active but no validated diagnostic technology currently exists to test at clinically relevant levels.

How CDI supports:

•Hydrogen and methane breath testing options provide gas-specific data that maps directly to symptom patterns.
•SIBO, IMO, and carbohydrate malabsorption testing covers a comprehensive trace gas workup from a single program.
•Non-invasive, at-home collection reduces patient barriers and supports higher completion rates.

Gas-specific data leads to a clearer differential and fewer diagnostic detours.

Full clinical resource here →
https://commdx.com/trace-gases-and-their-impact-on-the-gastrointestinal-gi-system/

If adding pediatric breath testing to your practice feels operationally complex, the issue usually isn't your team — it'...
03/11/2026

If adding pediatric breath testing to your practice feels operationally complex, the issue usually isn't your team — it's the model.

Pediatric patients with suspected SIBO or IMO present the same diagnostic challenge as adults, with one added layer: the testing experience has to work for a child. Invasive procedures aren't realistic. Unnecessary clinic visits add friction for families. And when the workup is cumbersome, follow-through drops.

CDI's pediatric hydrogen and methane breath test is designed specifically for that reality:

Order → CDI ships the 6-tube lactulose kit directly to the patient with complete, age-appropriate instructions.
Collect → At-home collection eliminates the clinic visit, reducing scheduling burden for your team and stress for the child.
Return → Pre-paid return shipping included, no family coordination required on your end.

How CDI supports pediatric practices:

• Non-invasive, at-home SIBO and IMO testing → designed for pediatric comfort, fewer barriers to completion.
• Carbohydrate malabsorption testing also available (fructose, lactose, sucrose) → comprehensive peds GI workup from a single program.
• Evidence-validated testing → reliable diagnostic data to guide treatment decisions.

Simpler workflow → higher completion → more actionable results for your youngest patients.

See the full pediatric program here → https://commdx.com/pediatric-breath-testing-for-sibo-imo/

03/09/2026

GI physiologist Jordan Haworth has a direct message for clinicians: IgG food sensitivity tests are not clinically validated — and patients are making dietary decisions based on them every day.

In Episode 6 of the Modern Gastro Podcast, Jordan explains that IgG tests frequently flag foods a patient tolerates without issue, leading to unnecessary restrictions. Over time, those restrictions can disrupt the gut microbiome — the very thing the patient was trying to protect. The test doesn't identify intolerance. It creates confusion.

What this means in practice:

• When patients present IgG results, treat them as unvalidated and redirect to objective testing before adjusting dietary guidance.
• Hydrogen and methane breath tests measure actual fermentation responses to specific substrates — that is quantifiable, actionable data.
• Frame the shift to patients clearly: breath testing replaces guesswork with results you can build a plan around.​

How CDI supports:

• Lactose, fructose, and sucrose breath test options → substrate-specific data for targeted dietary direction.
• Non-invasive, at-home collection → fewer barriers, higher patient follow-through.
• Detailed prep guides → better adherence, more reliable results.

Validated testing → targeted guidance → fewer unnecessary eliminations.

Hear Jordan's full perspective here:
https://commdx.com/episode-6-of-the-modern-gastro-podcast/

Symptoms alone can’t distinguish SIBO/IMO from carbohydrate malabsorption, and “diet trial first” can turn into weeks of...
03/06/2026

Symptoms alone can’t distinguish SIBO/IMO from carbohydrate malabsorption, and “diet trial first” can turn into weeks of uncertainty for both you and the patient.

Carbohydrate malabsorption breath testing (lactose, fructose, sucrose substrates) offers a non-invasive way to assess suspected sugar intolerance by measuring breath hydrogen after a defined challenge.​

The clinical risk of skipping structure is mislabeling: SIBO can contribute to false positives on carbohydrate malabsorption tests, which can drive unnecessary restriction, retesting, and delays in a clean plan.​

What changes in your workflow:
○ When clinically indicated, evaluate for SIBO first before interpreting carbohydrate malabsorption results.​
○ Use objective results to guide targeted restriction, not broad elimination by default.​
○ Standardize prep and instructions so results reflect physiology, not variability.​

How CDI supports:
○ Non-invasive, at-home testing → easier completion, fewer barriers.​
○ Lactose/fructose/sucrose options → clearer next steps for dietary guidance.
○ MyGI Gateway → streamlined ordering/tracking, less follow-up friction.​

Clear workflow → cleaner results → better decisions.

Full practical tool here →
https://commdx.com/carbohydrate-malabsorption-breath-testing-evidence-spotlight/

Breath test results without a nutritional plan are only half the answer.When SIBO or IMO is confirmed, the diagnostic wo...
03/04/2026

Breath test results without a nutritional plan are only half the answer.

When SIBO or IMO is confirmed, the diagnostic work is done — but the clinical question shifts immediately: what does this patient actually change in their diet, and based on what data?

Without a structured link between test results and dietary guidance, patients return with the same symptoms and clinicians restart the workup cycle.

A hydrogen and methane breath test identifies not just bacterial overgrowth but the specific gas profiles that inform whether a low-FODMAP approach, fiber adjustment, or carbohydrate restriction is the right next step — per research published in the American Journal of Gastroenterology.

What changes in your workflow:
• Use breath test results to drive substrate-specific dietary recommendations, not generic elimination protocols.
• For confirmed SIBO, use gas profile data to determine whether a low-FODMAP or fiber-modification approach is appropriate.
• Pair nutritional guidance with a follow-up testing plan so dietary changes can be objectively evaluated.

How CDI supports:
• SIBO, IMO, and carbohydrate malabsorption testing options → substrate-specific data to guide targeted dietary decisions.
• Non-invasive, at-home collection → easier patient completion, fewer barriers to follow-through.
• MyGI Gateway → streamlined result tracking, less time chasing data before the next clinical conversation.

Diagnosis without a dietary direction leaves the loop open. Close it with objective data.

Objective data → targeted nutrition → fewer repeat visits.

Full clinical resource here →
https://commdx.com/integrated-approaches-to-gi-health-combining-breath-testing-with-nutritional-strategies/

When patients feel guided through the process, they complete the test — fewer unreturned kits, less staff follow-up."Eve...
03/03/2026

When patients feel guided through the process, they complete the test — fewer unreturned kits, less staff follow-up.

"Everything was well organized.

The instructions were complete.

They confirmed every step."
— 5-star Google review

See how CDI supports patient completion → commdx.com/provider-resources/

When patients feel supported throughout the entire testing process, your practice doesn't have to fill that gap.Here's w...
03/03/2026

When patients feel supported throughout the entire testing process, your practice doesn't have to fill that gap.

Here's what one patient shared after completing their breath test at home:
"Everything was well organized. I received the package quickly with complete instructions. They did return calls as they said and were very informative — they made sure that answered my questions completely. They made sure to confirm with me that they received everything and that the process was complete."
— 5-star patient review, Google Dorene Thomas

When patients know exactly what to do, who to call, and that someone will follow through, they complete the test. That means fewer calls to your front desk, fewer missing forms chasing down results, and more kits returned with the data you need.​

How CDI supports that experience:
• Complete kit instructions included at shipment → patients arrive prepared, fewer prep-related questions to your team.
• Dedicated customer service team → patient questions handled directly, without routing through your practice.
• Pre-paid return shipping included → one less step patients can drop off.

If you'd like to see the full patient experience from kit shipment to result delivery, our team can walk you through it.

When Age Matters: Why SIBO & IMO Testing Isn't One-Size-Fits-AllA 7-year-old with chronic bloating and abdominal pain do...
03/02/2026

When Age Matters: Why SIBO & IMO Testing Isn't One-Size-Fits-All

A 7-year-old with chronic bloating and abdominal pain doesn't metabolize substrates the same way a 45-year-old does. Body size, gut transit time, and baseline microbial activity all vary by age—yet many breath tests ignore these differences.

The diagnostic gap:

Using adult protocols on pediatric patients can lead to false negatives, missed diagnoses, or inaccurate hydrogen and methane readings that don't reflect true microbial overgrowth.​

Why CDI offers age-specific SIBO & IMO breath tests:

Pediatric-calibrated protocols account for smaller body mass and faster intestinal transit
Age-appropriate substrate dosing ensures accurate hydrogen and methane measurement without overwhelming younger GI systems
Specialized reference ranges reflect developmental differences in gut microbiome composition
Same diagnostic rigor, tailored application—both adult and pediatric tests use the 10-tube system for comprehensive microbial profiling​

Bottom line:

Precision diagnosis requires precision protocols. One lab partner, comprehensive age coverage, accurate results across your entire patient population.​
Better testing → better outcomes → at every age.

📧 Questions about selecting the right breath test for your pediatric or adult patients? Contact Provider Relations at providerservices@commdx.com

Constipation-Dominant? Think Methane First.Not every patient with GI symptoms needs methane breath testing. But patients...
03/02/2026

Constipation-Dominant? Think Methane First.

Not every patient with GI symptoms needs methane breath testing. But patients with constipation as the dominant phenotype? That's where methane testing matters most.

The clinical pearl:

Methane breath testing should be strategically reserved for constipation-dominant presentations—not broadly applied across all functional GI complaints. This targeted approach prevents unnecessary testing while identifying IMO in the exact population most likely to benefit from treatment.

Why constipation phenotype determines testing strategy:

Methane-producing archaea slow intestinal transit. That's the mechanism behind constipation in IMO. When constipation dominates the clinical picture (rather than diarrhea or mixed patterns), pretest probability for IMO increases significantly.
Testing the right patients means higher diagnostic yield and more efficient resource utilization.

The prevalence data that guides decision-making:

IMO prevalence varies dramatically across patient populations:
Normal populations: low baseline prevalence
IBS patients (constipation-dominant): elevated prevalence
IBD patients with functional overlay: variable prevalence

Understanding these population-level differences helps clinicians apply breath testing where it delivers the most clinical value—not as a reflex order, but as a precision diagnostic tool.

How CDI supports tailored diagnostic approaches:
✅ Flexible substrate options — glucose or lactulose breath tests for SIBO/IMO based on clinical presentation
✅ Constipation-specific protocols — methane measurement optimized for IMO detection
✅ Adult and pediatric testing — age-appropriate protocols across patient populations
✅ Consensus guideline alignment — testing methodology rooted in North American Consensus and ACG Guidelines
✅ Provider Relations consultation — support for substrate selection and patient population targeting

The practice-level benefit:
When you reserve methane testing for constipation-dominant patients, you're not just following guidelines—you're maximizing diagnostic efficiency. Higher positive rates. More targeted treatments. Better outcomes in the patients who need it most.
Precision diagnosis isn't about testing everyone. It's about testing the right patients.

Constipation-dominant symptoms + methane testing + targeted treatment = efficient IMO diagnosis.

💬 Clinicians: How do you decide which IBS patients to test for IMO? Do you use symptom phenotype to guide testing, or test broadly? Share your approach below.
📧 Questions about substrate selection or testing protocols? Contact Provider Relations at providerservices@commdx.com

When Symptoms Return After Treatment: A SIBO Case StudyA 42-year-old celiac patient achieved symptom relief on a strict ...
02/27/2026

When Symptoms Return After Treatment: A SIBO Case Study

A 42-year-old celiac patient achieved symptom relief on a strict gluten-free diet. Four months later, bloating and diarrhea return. Celiac serology comes back negative—confirming gluten-free adherence.

What's your next step?

The diagnostic crossroads:

Option A: Assume dietary non-compliance despite negative serology, order endoscopy with biopsy to rule out refractory celiac disease.

Option B: Recognize that celiac patients with recurrent GI symptoms have a 28% pretest probability of SIBO and order breath testing first.

Why this scenario demands objective testing:

Celiac disease and SIBO share overlapping symptoms—bloating, diarrhea, abdominal discomfort.

When symptoms recur despite confirmed gluten avoidance, clinicians face diagnostic ambiguity: Is this refractory celiac, SIBO, carbohydrate malabsorption, or another functional GI disorder?

Without breath testing, the default pathway often leads to invasive endoscopy when a non-invasive test could provide the answer faster and with less patient burden.

The clinical equation:

Negative celiac serology + compatible GI symptoms + 28% SIBO prevalence in this population = breath test indication
This isn't guessing—it's evidence-based triage that prevents unnecessary procedures while accelerating diagnosis.

How CDI supports rapid diagnosis when symptoms recur:

✅ 24-hour turnaround — results available within one day to inform next steps without delays
✅ Real-time MyGI Gateway tracking — monitor kit status from distribution to lab receipt
✅ Non-invasive, at-home collection — no scope prep, no sedation, no procedure scheduling backlog
✅ Comprehensive testing menu — SIBO, IMO, and carbohydrate malabsorption panels available
✅ Provider Relations support — clinical consultation on test selection and interpretation

The practice-level impact:

Faster diagnosis means faster treatment decisions. Patients aren't left waiting weeks for endoscopy scheduling when breath testing can rule SIBO in or out within 24 hours of sample receipt.

When symptoms return, time matters—and non-invasive testing protects both diagnostic accuracy and patient experience.

Symptom recurrence + negative serology + breath testing = efficient, evidence-based diagnosis.

💬 Clinicians: How do you approach recurrent GI symptoms in celiac patients with confirmed dietary adherence? Do you test for SIBO before considering endoscopy? Share your diagnostic workflow below.

📧 Questions about breath testing in complex cases? Contact Provider Relations at providerservices@commdx.com

Address

Salem, MA

Opening Hours

Monday 9am - 5pm
Tuesday 9am - 5pm
Wednesday 9am - 5pm
Thursday 9am - 5pm
Friday 9am - 5pm

Telephone

+18882585966

Website

Alerts

Be the first to know and let us send you an email when Commonwealth Diagnostics International posts news and promotions. Your email address will not be used for any other purpose, and you can unsubscribe at any time.

Contact The Practice

Send a message to Commonwealth Diagnostics International:

Shortcuts

Share

Share on Facebook Share on Twitter Share on LinkedIn
Share on Pinterest Share on Reddit Share via Email
Share on WhatsApp Share on Instagram Share on Telegram

Category