Irritable Bowel Syndrome, Particularly the Constipation-Predominant Form, Involves an Increase in Methanobrevibacter smithii, Which Is Associated with Higher Methane Production.
- Author:
Ujjala GHOSHAL
1
;
Ratnakar SHUKLA
;
Deepakshi SRIVASTAVA
;
Uday C GHOSHAL
Author Information
- Publication Type:Original Article
- Keywords: Methanogenic flora; Real-time polymerase chain reaction; Lactulose hydrogen breath test; Gut transit
- MeSH: Area Under Curve; Breath Tests; Constipation; Diarrhea; Fasting; Feces; Humans; Hydrogen; Irritable Bowel Syndrome*; Lactulose; Methane*; Methanobrevibacter*; Real-Time Polymerase Chain Reaction; ROC Curve; Sensitivity and Specificity
- From:Gut and Liver 2016;10(6):932-938
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Because Methanobrevibacter smithii produces methane, delaying gut transit, we evaluated M. smithii loads in irritable bowel syndrome (IBS) patients and healthy controls (HC). METHODS: Quantitative real-time polymerase chain reaction for M. smithii was performed on the feces of 47 IBS patients (Rome III) and 30 HC. On the lactulose hydrogen breath test (LHBT, done for 25 IBS patients), a fasting methane result ≥10 ppm using 10 g of lactulose defined methane-producers. RESULTS: Of 47, 20 had constipation (IBS-C), 20 had diarrhea (IBS-D) and seven were not sub-typed. The M. smithii copy number was higher among IBS patients than HC (Log₁₀5.4, interquartile range [IQR; 3.2 to 6.3] vs 1.9 [0.0 to 3.4], p<0.001), particularly among IBS-C compared to IBS-D patients (Log₁₀6.1 [5.5 to 6.6] vs 3.4 [0.6 to 5.7], p=0.001); the copy number negatively correlated with the stool frequency (R=−0.420, p=0.003). The M. smithii copy number was higher among methane-producers than nonproducers (Log₁₀6.4, IQR [5.7 to 7.4] vs 4.1 [1.8 to 5.8], p=0.001). Using a receiver operating characteristic curve, the best cutoff for M. smithii among methane producers was Log₁₀6.0 (sensitivity, 64%; specificity, 86%; area under curve [AUC], 0.896). The AUC for breath methane correlated with the M. smithii copy number among methane producers (r=0.74, p=0.008). Abdominal bloating was more common among methane producers (n=9/11 [82%] vs 5/14 [36%], p=0.021). CONCLUSIONS: Patients with IBS, particularly IBS-C, had higher copy numbers of M. smithii than HC. On LHBT, breath methane levels correlated with M. smithii loads.
