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Bacterial overgrowth and methane production in children with encopresis

Alycia Leiby1, Devendra Mehta, Vani Gopalareddy

  • 1Division of Pediatric Gastroenterology and Nutrition, Alfred I. duPont Hospital for Children, Wilmington, DE 19803, USA.

The Journal of Pediatrics
|December 29, 2009
PubMed
Abstract

Insights

Children with encopresis and fecal impaction show higher rates of small intestinal bacterial overgrowth (SIBO) and methane production, which correlates with more severe impaction.

Area of Science:

  • Pediatric Gastroenterology
  • Microbiome Research
  • Digestive Health

Background:

  • Encopresis, characterized by fecal incontinence in children, is often linked to functional gastrointestinal disorders.
  • Small intestinal bacterial overgrowth (SIBO) and altered methane metabolism are implicated in various gastrointestinal conditions.

Purpose of the Study:

  • To investigate the prevalence of SIBO and methane production in children diagnosed with encopresis.
  • To explore the association between methane production, SIBO, and fecal impaction severity in pediatric encopresis.

Main Methods:

  • Assessed radiographic fecal impaction (FI) scores in children with encopresis.
  • Administered hypoosmotic lactulose breath tests to patients (n=50) and controls (n=39).
  • Compared breath test results (SIBO, methane production) with FI scores.

Main Results:

  • SIBO was detected in 42% of encopresis patients versus 23% of controls (P=0.06).
  • Methane production was significantly higher in encopresis patients (56%) compared to controls (23.1%) (P<0.01).
  • Elevated fasting methane levels were observed in 48% of encopresis patients versus 10.3% of controls (P<0.01).
  • Higher FI scores were associated with methane production in encopresis patients (P<0.01).

Conclusions:

  • Children with encopresis and fecal impaction exhibit a greater prevalence of SIBO and elevated methane production.
  • Methane production correlates with increased severity of colonic impaction in encopretic children.
  • Further research is warranted to elucidate the role of methane production in the pathogenesis of SIBO and encopresis.

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