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[Breath methane in children with chronic constipation]
Ana Cristina Fontenele Soares1, Soraia Tahan, Ulysses Fagundes-Neto
1Disciplina de Gastroenterologia Pediátrica, Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP.
Insights
Methane production in children is linked to chronic constipation, especially with fecal soiling. Treatment for constipation reduced methane levels, indicating a connection between gut health and methane gas in children.
Area of Science:
- Pediatric Gastroenterology
- Microbiology
- Respiratory Medicine
Context:
- Methane is an intestinal gas found in the expired air of approximately 10% of children.
- Functional chronic constipation is a common pediatric condition.
- The presence and levels of methane gas in children's breath can vary.
Purpose:
- To investigate methane production in children diagnosed with functional chronic constipation.
- To measure methane concentration in expired air before and after induced bowel movements.
- To assess the relationship between methane production and constipation severity, particularly with fecal soiling.
Summary:
- Methane production was detected in 86.3% of constipated children with fecal soiling, compared to 29.2% without soiling.
- Following a six-week constipation therapy, methane production decreased by 65.2%.
- In children with impacted stool, methane concentration significantly reduced after a bowel movement was induced by a phosphate enema (from 21.5 ppm to 11.0 ppm).
Impact:
- Methane production is significantly associated with chronic constipation, particularly when accompanied by fecal soiling in children.
- Therapeutic interventions aimed at reducing constipation and impacted stool appear to decrease methane production.
- These findings highlight methane breath analysis as a potential diagnostic or monitoring tool in pediatric functional bowel disorders.
Rationale:
Methane is an intestinal gas which may be excreted in the expired air of about 10% of children.
Objective:
The aims of this study were to investigate methane production by children with functional chronic constipation and methane concentration in the expired air before and after a bowel movement induced by a phosphate enema.
Methods:
Seventy-five patients with functional chronic constipation aged from 3 to 13 years were studied. Methane concentration in the expired air was determined using a gas chromatograph (Quintron, model 12i). Methane production was considered present if the breath methane concentration was equal or greater than 3 ppm.
Results:
Methane production was present in 44 (86.3%) of 51 patients with constipation and fecal soiling versus only 7 (29.2%) of 24 patients with constipation without fecal soiling. After six weeks of therapy for constipation, the number of methane producers decreased by 65.2%. None of the 10 children with normal intestinal habit produced methane. Expired air methane concentration was determined before and after a bowel movement induced by a phosphate enema in 20 patients with impacted stool. From these 20 patients, 12 were methane producers. The median (percentiles 25 and 75 between parenthesis) of methane concentration decreased from 21.5 (15.0-25.5) ppm before to 11.0 (4.0-12.5) ppm after the bowel movement.
Conclusion:
Methane production was associated with chronic constipation with soiling and decreased when impacted stool decreased.