Pimentel Mark, Mayer Andrew G, Park Sandy, Chow Evelyn J, Hasan Aliya, Kong Yuthana
GI Motility Program, Bums and Allen Research Center, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.
Dig Dis Sci. 2003 Jan;48(1):86-92. doi: 10.1023/a:1021738515885.
It has recently been determined that there is an increased prevalence of bacterial overgrowth in IBS. Since there are two gases (hydrogen and methane) measured on lactulose breath testing, we evaluated whether the different gas patterns on lactulose breath testing coincide with diarrhea and constipation symptoms in IBS and IBD. Consecutive patients referred to the gastrointestinal motility program at Cedars-Sinai Medical Center for lactulose breath testing were given a questionnaire to evaluate their gastrointestinal symptoms. Symptoms were graded on a scale of 0-5. Upon completion of the breath test, the results were divided into normal, hydrogen only, hydrogen and methane, and methane only positive breath tests. A comparison of all subjects and IBS subjects was undertaken to evaluate diarrhea and constipation with regards to the presence or absence of methane. This was further contrasted to Crohn's and ulcerative colitis (UC) patients in the database. After exclusion criteria, 551 subjects from the database were available for comparison. Of the 551 subjects (P < 0.05, one-way ANOVA) and in a subgroup of 296 IBS subjects (P < 0.05, one-way ANOVA), there was a significant association between the severity of reported constipation and the presence of methane. The opposite was true for diarrhea (P < 0.001). If a breath test was methane positive, this was 100% associated with constipation predominant IBS. Furthermore, IBS had a greater prevalence of methane production than Crohn's or UC. In fact, methane was almost nonexistent in the predominantly diarrheal conditions of Crohn's and UC. In conclusion, a methane positive breath test is associated with constipation as a symptom.
最近已确定，肠易激综合征（IBS）中细菌过度生长的患病率有所增加。由于在乳果糖呼气试验中测量两种气体（氢气和甲烷），我们评估了乳果糖呼气试验中不同的气体模式是否与IBS和炎症性肠病（IBD）中的腹泻和便秘症状相符。在雪松西奈医疗中心胃肠动力项目接受乳果糖呼气试验的连续患者被给予一份问卷，以评估他们的胃肠道症状。症状按0 - 5级评分。呼气试验完成后，结果分为正常、仅氢气、氢气和甲烷以及仅甲烷阳性呼气试验。对所有受试者和IBS受试者进行比较，以评估腹泻和便秘与甲烷存在与否的关系。这进一步与数据库中的克罗恩病和溃疡性结肠炎（UC）患者进行对比。经过排除标准后，数据库中有551名受试者可供比较。在551名受试者中（P < 0.05，单因素方差分析）以及在296名IBS受试者的亚组中（P < 0.05，单因素方差分析），报告的便秘严重程度与甲烷的存在之间存在显著关联。腹泻情况则相反（P < 0.001）。如果呼气试验甲烷呈阳性，则100%与以便秘为主的IBS相关。此外，IBS产生甲烷的患病率高于克罗恩病或UC。事实上，在克罗恩病和UC以腹泻为主的情况下，甲烷几乎不存在。总之，甲烷阳性呼气试验与便秘症状相关。
