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Functional Constipation
Received: 13.01.2012 Accepted: 25.04.2012
J Gastrointestin Liver Dis
June 2012 Vol. 21 No 2, 157-163
Address for correspondence: Manuele Furnari, M.D.
Gastroenterology Unit
Department of Internal Medicine
University of Genoa
16132, Genoa, Italy
E-mail: manuelefurnari@
Reassessment of the Role of Methane Production between
Irritable Bowel Syndrome and Functional Constipation
Manuele Furnari, Edoardo Savarino, Luca Bruzzone, Alessandro Moscatelli, Lorenzo Gemignani, Edoardo G Giannini,
Patrizia Zentilin, Pietro Dulbecco, Vincenzo Savarino
Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy
Abstract
Background Aims: Modifications of intestinal gas due
to changes in microbiota may produce different symptoms.
Our aim was to assess whether different patterns of hydrogen
(H2) and methane (CH4) excretion were related to some
intestinal disturbances. Methods. Six hundred and twenty-
nine consecutive patients underwent a 50g-glucose breath
test (GBT) on account of intestinal symptoms, which were
evaluated by means of a questionnaire. “H2-producers” and
“CH4-producers” were defined as with the presence of H2
peak 12ppm more than the basal sample and mean CH4
excretion of 2ppm, respectively. Forty healthy subjects were
studied as controls. Results. A small intestinal bacterial
overgrowth was found in 45 cases (7.2%) and was associated
with older age (p=0.0122). Methane production occurred
in 32.3% of the study population. Methane excretion was
strictly related to chronic constipation (p0.001). Median
CH4 excretion was higher in constipated patients compared
with patients with normal daily stools (p=0.0406) and even
more with patients complaining of diarrhea (p=0.0011).
Different criteria for defining “methane-producers” provided
similar results. Mean methane excretion of “methane
producers” was 30.3ppm in functional constipation and
21.5ppm in constipation-irritable bowel syndrome (C-IBS)
(p=0.0458). Con
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