Methane on Breath Testing Is Associated with Constipation: A Systematic Review and Meta-analysis

Kunkel, David C.; Basseri, Robert J.; Makhani, Marc; Chong, Kelly; Chang, Christopher; Pimentel, Mark

doi:10.1007/s10620-011-1590-5

Cited by 158 publications

(122 citation statements)

References 45 publications

(55 reference statements)

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“…It is important to consider the above fi ndings using an evidencebased medicine approach. A recent meta-analysis evaluated the existing literature comparing the presence of methane and constipation ( 31 ). Although not all studies have confi rmed these results, most do to support a signifi cant association.…”

Section: Is There a Role For Methane In Constipation-predominant Irrimentioning

confidence: 99%

Methanogens in Human Health and Disease

Pimentel¹,

Gunsalus²,

Rao³

et al. 2012

Am J Gastroenterol Suppl

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Section: Is There a Role For Methane In Constipation-predominant Irrimentioning

confidence: 99%

Methanogens in Human Health and Disease

Pimentel¹,

Gunsalus²,

Rao³

et al. 2012

Am J Gastroenterol Suppl

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“…In a meta-analysis of 1277 IBS patients, we found that methane was associated with constipation, with a pooled OR=3.51 (CI=2.00-6.16) [25]. Further, treatment with the non-absorbable antibiotics neomycin and rifaximin both eliminates methane and improves constipation [26], particularly in C-IBS subjects with successful eradication of methane on breath test (Pimentel et al, submitted), suggesting that methane itself is the cause of the constipation.…”

Section: Introductionmentioning

confidence: 97%

Methane-producing human subjects have higher serum glucose levels during oral glucose challenge than non-methane producers: a pilot study of the effects of enteric methanogens on glycemic regulation

Mathur¹,

Goyal²,

Kim³

et al. 2014

Res J Endocrinol Metab

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Background: Recent studies support that intestinal microbes contribute to human disease, and enteric methanogens have been specifically linked to altered gut metabolism and weight gain. In this study, we tested whether methane on breath test (as a surrogate for colonization with the predominant methanogen Methanobrevibacter smithii) is associated with altered glucose tolerance in humans. Methods: Consecutive methane producing (methane ≥3ppm, N=5) and non-methane producing (methane <3ppm, N=15) subjects undergoing lactulose breath test at our center were recruited and subjected to a 75 g oral glucose tolerance test (OGTT). Results: The average age of methane-producing subjects was 48.8±10.0 vs. 37.7±12.1 for non-methane subjects (P=0.17). Methane and non-methane subjects also had comparable mean body mass index (BMI) (23.9±0.2 vs. 25.0±8.0 kg/m2; P=0.53) and baseline insulin resistance (HOMA-IR) (1.32±0.72 vs. 2.21±1.52; P=0.23). During 180 minutes post-glucose load, methane producers had greater serum glucose area-under-the-curve (AUC) (774.2±140.3 mg/dL) than non-methane subjects (585.5±128.3 mg/dL) (P=0.03), but similar insulin AUC (217.76±122.08 μU/mL vs. 215.37±75.02 μU/mL, respectively). Conclusions: Individuals with methane on breath test (reflecting higher colonization with enteric methanogens, predominantly M. smithii) may have impaired glucose tolerance when challenged with a high carbohydrate load, and may also have a higher susceptibility to hyperglycemia which appears to be independent of basal insulin resistance and BMI.

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“…34,36 Methane production as a diagnostic test has been shown to be very accurate in predicting IBS-C, with a sensitivity of 91% and a specificity of 81.3%. 33 Two earlier studies support that methane is associated with the severity of IBS-C, 33,39 and although methane does not account for all IBS-C patients, a meta-analysis including a total of 1277 subjects (319 methane producers and 958 methane non-producers) showed that methane is significantly associated with IBS-C. 40 Another study demonstrated that methane-producing IBS subjects had small bowel movements, straining, lactose intolerance, and weight loss. 34 Furthermore, objective measures of constipation tracking stool habits showed that the degree of methane production on LBT correlated with the severity of constipation.…”

Section: -mentioning

confidence: 99%

Biomarkers of Irritable Bowel Syndrome

Kim

Lin

Pimentel

2017

J Neurogastroenterol Motil

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Traditionally, irritable bowel syndrome (IBS) has not been regarded as an organic disease, and the pathophysiology of IBS is heterogeneous. Currently, the diagnosis of IBS is based upon the Rome diagnostic criteria. The performance of these criteria is only modest in predicting IBS, and moreover their validation is lacking. Additionally, as functional symptoms are common in the general population, healthy controls or volunteers are difficult to define and there is currently no definition of "normal" in the Rome criteria. Due to the weaknesses of the current diagnostic criteria, patients and doctors expect new gold standard diagnostic tools. Various etiologic mechanisms result in potential biomarkers. The focus of this research has been to find non-invasive biomarkers from serum, breath gas, and fecal materials. Though biomarkers should be based on biological and pathogenic processes, most biomarkers for IBS have been developed to identify organic diseases and therefore eliminate IBS. To date, these types of biomarkers for IBS have been disappointing. The purposes of developing biomarkers include improvement of diagnosis, differentiation from other organic diseases, and discrimination of IBS subtypes. A true mechanistic biomarker would make it possible to rule in IBS, rather than to rule out other organic diseases. New serologic biomarkers for diarrhea-predominant IBS have been introduced based on the pathophysiologic findings from a rat model and validation in a large-scale clinical trial. Further investigations of abnormal organic findings from each subtype of IBS would enable the development of new, simple subtype-specific biomarkers.

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Methane on Breath Testing Is Associated with Constipation: A Systematic Review and Meta-analysis

Cited by 158 publications

References 45 publications

Methanogens in Human Health and Disease

Methanogens in Human Health and Disease

Methane-producing human subjects have higher serum glucose levels during oral glucose challenge than non-methane producers: a pilot study of the effects of enteric methanogens on glycemic regulation

Biomarkers of Irritable Bowel Syndrome

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