儿童便秘中细菌过度生长和甲烷生成。

Bacterial overgrowth and methane production in children with encopresis.

机构信息

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

出版信息

J Pediatr. 2010 May;156(5):766-70, 770.e1. doi: 10.1016/j.jpeds.2009.10.043. Epub 2009 Dec 29.

DOI:10.1016/j.jpeds.2009.10.043

PMID:20036380

Abstract

OBJECTIVES

To assess the prevalence of small intestinal bacterial overgrowth (SIBO) and methane production in children with encopresis.

STUDY DESIGN

Radiographic fecal impaction (FI) scores were assessed in children with secondary, retentive encopresis and compared with the breath test results. Breath tests with hypoosmotic lactulose solution were performed in both the study patients (n = 50) and gastrointestinal control subjects (n = 39) groups.

RESULTS

The FI scores were significantly higher in the patients with encopresis who were methane producers (P < .01). SIBO was diagnosed in 21 of 50 (42%) patients with encopresis and 9 of 39 (23%) of control subjects (P = .06). Methane was produced in 56% of the patients with encopresis versus 23.1% of the control subjects in the gastrointestinal group (P < .01). Fasting methane level was elevated in 48% versus 10.3 %, respectively (P < .01).

CONCLUSIONS

Children with FI and encopresis had a higher prevalence of SIBO, elevated basal methane levels, and higher methane production. Methane production was associated with more severe colonic impaction. Further study is needed to determine whether methane production is a primary or secondary factor in the pathogenesis of SIBO and encopresis.

摘要

目的

评估患有便秘的儿童小肠细菌过度生长（SIBO）和甲烷生成的患病率。

研究设计

对继发性、潴留性便秘儿童的放射性粪便嵌塞（FI）评分进行评估，并与呼气试验结果进行比较。对研究患者（n=50）和胃肠道对照组（n=39）进行低渗乳糖溶液呼气试验。

结果

甲烷生成患者的 FI 评分明显更高（P<0.01）。在 50 名便秘患者中，21 名（42%）诊断为 SIBO，39 名对照组中有 9 名（23%）（P=0.06）。在胃肠道组中，便秘患者的甲烷生成率为 56%，而对照组为 23.1%（P<0.01）。空腹甲烷水平分别升高 48%和 10.3%（P<0.01）。