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Methanogenic flora is associated with altered colonic transit but not stool characteristics in constipation without

Ashok Attaluri1, Michelle Jackson, Jessica Valestin

  • 1Division of Gastroenterology/Hepatology, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa 52242-1009, USA.

The American Journal of Gastroenterology
|December 3, 2009
PubMed
Abstract

Insights

Methanogenic flora is more prevalent in patients with slow transit constipation. Methane production correlates with colonic transit time but not stool consistency in constipated individuals.

Area of Science:

  • Gastroenterology
  • Microbiome Research
  • Digestive Physiology

Background:

  • Approximately 35% of humans harbor methane-producing gut flora.
  • Methane-producing irritable bowel syndrome (IBS) is often associated with constipation.
  • Animal models suggest methane slows intestinal transit, but its role in human colonic transit and constipation is unclear.

Purpose of the Study:

  • To investigate the prevalence of methanogenic flora in patients with slow transit (ST) constipation and normal transit (NT) constipation.
  • To examine the association between methanogenic flora and colonic transit or stool characteristics in constipation.
  • To compare methanogenic flora prevalence and methane production in constipated patients versus non-constipated controls.

Main Methods:

  • 96 chronic constipation (CC) patients underwent radio-opaque marker (ROM) transit studies to classify as ST or NT.
  • Breath tests were used to assess methane production in 202 constipated subjects and 106 controls.
  • Methanogenic flora was defined by a baseline methane (CH4) level of ≥3 p.p.m.; stool diaries assessed frequency and consistency.

Main Results:

  • The prevalence of methanogenic flora was significantly higher in ST constipation (75%) compared to NT (44%) and controls (28%).
  • ST patients exhibited higher methane production than NT patients and controls; NT patients also showed higher production than controls.
  • Methane production correlated with colonic transit but not with stool characteristics.

Conclusions:

  • Methanogenic flora is associated with chronic constipation.
  • The prevalence and methane production were elevated in ST constipation compared to NT constipation.
  • Methane production is linked to colonic transit, indicating a role in stool transport rather than stool consistency.

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