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Methane on Breath Testing Is Associated with Constipation: A Systematic Review and Meta-analysis

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Abstract

Background

A growing body of literature suggests an association between methane and constipation. Studies also link degree of methane production to severity of constipation and have shown constipation is improved following antibiotics.

Aims

We aim to conduct a systematic review and meta-analysis to examine the cumulative evidence regarding the association between methane and constipation.

Methods

A literature search was performed using MEDLINE and Embase to identify studies where the presence (or absence) of methane was assessed in constipated subjects. Search terms included “methane,” “breath test,” “constipation,” “motility,” “transit,” “irritable bowel syndrome” and/or “IBS.” Pooled odds ratios were generated using a random effects model. In a separate analysis, studies that measured intestinal transit in methane and non-methane subjects were systematically reviewed.

Results

Nine studies met inclusion criteria for the meta-analysis. Among these, 1,277 subjects were examined by breath testing (N = 319 methane producers and N = 958 methane non-producers). Pooling all studies, a significant association was found between methane on breath test and constipation (OR = 3.51, CI = 2.00–6.16). Among adults only, methane was significantly associated with constipation (OR = 3.47, CI = 1.84–6.54). Similar results were seen when only examining subjects with IBS (OR = 3.60, CI = 1.61–8.06). The systematic review identified eight additional papers which all demonstrated an association between methane and delayed transit.

Conclusions

We demonstrate that methane present on breath testing is significantly associated with constipation in both IBS and functional constipation. These results suggest there may be merit in using breath testing in constipation. Moreover, methane may be used to identify candidates for antibiotic treatment of constipation.

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Acknowledgments

We would like to thank the Beatrice and Samuel A. Seaver Foundation for their ongoing support of our research in the GI Motility Program at Cedars-Sinai Medical Center.

Conflict of interest

There are no commercial associations that might pose or create a conflict of interest with information presented in this submitted manuscript such as consultancies, stock ownership, or patent licensing arrangements. All sources of funds supporting the completion of this manuscript are under the auspices of the Cedars-Sinai Medical Center.

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Authors and Affiliations

  1. GI Motility Program, Cedars-Sinai Medical Center, 8730 Alden Drive, Thalians Building, 2nd Floor East, Los Angeles, CA, 90048, USA

    David Kunkel, Robert J. Basseri, Marc D. Makhani, Christopher Chang & Mark Pimentel

  2. Division of General Internal Medicine and Health Services Research, UCLA Department of Medicine, Los Angeles, CA, USA

    Kelly Chong

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  1. David Kunkel
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  2. Robert J. Basseri
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  3. Marc D. Makhani
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  4. Kelly Chong
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  5. Christopher Chang
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  6. Mark Pimentel
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Correspondence to Mark Pimentel.

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Kunkel, D., Basseri, R.J., Makhani, M.D. et al. Methane on Breath Testing Is Associated with Constipation: A Systematic Review and Meta-analysis. Dig Dis Sci 56, 1612–1618 (2011). https://doi.org/10.1007/s10620-011-1590-5

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  • DOI: https://doi.org/10.1007/s10620-011-1590-5

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