Functional Constipation.pdf

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