Breath methane in functional constipation: response to treatment with Ispaghula husk

Area of Science:

• Gastroenterology
• Microbiome Research
• Digestive Health

Background:

• Colonic fermentation produces hydrogen (H2) and methane (CH4) in methane-producing (M+) individuals.
• Methane production is potentially linked to chronic constipation (CC) and altered gut motility.
• Investigating CH4 in CC is crucial for understanding disease pathophysiology and treatment response.

Purpose of the Study:

• To compare CH4 production in CC patients versus healthy volunteers (HV).
• To evaluate if CH4 production influences therapeutic response to Ispaghula husk in CC.
• To assess the correlation between CH4, H2 production, and colonic transit time (CTT).

Main Methods:

• 48 CC patients and 19 HV underwent symptom diaries, dietary questionnaires, lactulose breath tests (LBT) for H2/CH4, and CTT assessment.
• LBT measured peak and area under the curve (AUC) for H2 and CH4.
• CC patients were reassessed after 4-week Ispaghula husk treatment.

Main Results:

• CC patients showed significantly longer CTT and higher H2/CH4 production than HV.
• A correlation was observed between CH4 production and CTT (r=0.51).
• Treatment response rates were similar in M+ and M- patients; Ispaghula husk reduced CTT and CH4 levels in M+ individuals.

Conclusions:

• CH4 production is associated with CC pathophysiology but does not impede response to Ispaghula husk.
• Ispaghula husk effectively improves CTT and reduces CH4 in M+ patients.
• Further research is needed to validate CH4 as a biomarker for CC.