Division of Gastroenterology/Hepatology, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa 52242-1009, USA.
Am J Gastroenterol. 2010 Jun;105(6):1407-11. doi: 10.1038/ajg.2009.655. Epub 2009 Dec 1.
About 35% of humans have methane-producing gut flora. Methane-producing irritable bowel syndrome (IBS) subjects are generally constipated. In animal models, methane infusion slows intestinal transit. Whether methanogenic flora alters colonic transit or stool characteristics and its relationship to constipation is unclear. The aim of this study was to examine the prevalence and association of methanogenic flora in patients with slow transit (ST) constipation and normal transit (NT) constipation and non-constipated controls.
Ninety-six consecutive subjects with chronic constipation (CC) (Rome III) were evaluated with radio-opaque marker (ROM) transit studies and were classified as ST (>20% ROM retention) or NT. All constipated subjects and 106 non-constipated controls underwent breath tests to assess methane production. Baseline CH4 of >or=3 p.p.m. was used to define presence of methanogenic flora. Stool frequency and consistency were assessed using a prospective stool diary. Correlation analyses were performed.
Forty-eight subjects had ST and 48 had NT. Prevalence of methanogenic flora was higher (P<0.05) in ST (75%) compared to NT (44%) or controls (28%). ST patients had higher methane production compared to NT and controls (P<0.05). NT patients also produced more methane compared to controls (P<0.05). There was moderate(P<0.05) correlation among baseline, peak, and area under the curve (AUC) of methane response with colonic transit but not with stool characteristics.
Presence of methanogenic flora is associated with CC. Methane production after carbohydrate challenge and its prevalence were higher in ST than NT, although stool characteristics were similar in both groups. Methane production correlated with colonic transit, suggesting an association with stool transport but not with stool characteristics.
大约 35%的人类肠道中存在产生甲烷的菌群。产生甲烷的肠易激综合征（IBS）患者通常便秘。在动物模型中，甲烷输注会减缓肠道转运。目前尚不清楚产甲烷菌群是否会改变结肠转运或粪便特征及其与便秘的关系。本研究旨在检查慢传输（ST）便秘、正常传输（NT）便秘和非便秘对照患者中甲烷产生菌群的患病率和相关性。
对 96 例慢性便秘（罗马 III 标准）患者进行放射性标志物（ROM）转运研究，并根据 ROM 保留率将其分为 ST（>20%ROM 保留）或 NT。所有便秘患者和 106 例非便秘对照者均进行呼气试验以评估甲烷生成。基线 CH4 >或=3 ppm 用于定义产甲烷菌群的存在。使用前瞻性粪便日记评估粪便频率和稠度。进行相关性分析。
48 例患者存在 ST，48 例患者存在 NT。ST 组（75%）产甲烷菌群的患病率高于 NT 组（44%）或对照组（28%）（P<0.05）。ST 患者的甲烷生成量高于 NT 组和对照组（P<0.05）。NT 患者的甲烷生成量也高于对照组（P<0.05）。基线、峰值和甲烷反应曲线下面积（AUC）与结肠转运之间存在中度相关性（P<0.05），但与粪便特征无关。
产甲烷菌群的存在与 CC 相关。碳水化合物挑战后甲烷的产生和其患病率在 ST 中高于 NT，尽管两组的粪便特征相似。甲烷的产生与结肠转运相关，提示与粪便转运有关，但与粪便特征无关。
