Abstract
Purpose
Among irritable bowel syndrome (IBS) patients, breath methane producers overwhelmingly have constipation predominance (C-IBS). Although the most common methanogen in humans is Methanobrevibacter smithii, incidence and type of methanogenic bacteria in C-IBS patients are unknown.
Methods
By use of a questionnaire and lactulose breath testing, subjects with Rome II C-IBS and methane (>3 ppm) were selected (n = 9). The control group included subjects with IBS who had no breath methane (n = 10). Presence of bacterial DNA was assessed in a stool sample of each subject by quantitative-PCR using universal 16S rDNA primer. M. smithii was quantified by use of a specific rpoB gene primer.
Results
M. smithii was detected in both methane and non-methane subjects. However, counts and relative proportion of M. smithii were significantly higher for methane-positive than for methane-negative subjects (1.8 × 107 ± 3.0 × 107 vs 3.2 × 105 ± 7.6 × 105 copies/g wet stool, P < 0.001; and 7.1 ± 6.3 % vs 0.24 ± 0.47 %, P = 0.02 respectively). The minimum threshold of M. smithii resulting in positive lactulose breath testing for methane was 4.2 × 105 copies/g wet stool or 1.2 % of total stool bacteria. Finally, area-under-curve for breath methane correlated significantly with both absolute quantity and percentage of M. smithii in stool (R = 0.76; P < 0.001 and R = 0.77; P < 0.001 respectively).
Conclusions
M. smithii is the predominant methanogen in C-IBS patients with methane on breath testing. The number and proportion of M. smithii in stool correlate well with amount of breath methane.
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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
Dr Mark Pimentel is a consultant for and has grants from Salix Pharmaceuticals. Cedars-Sinai has a licensing agreement with Salix Pharmaceuticals. All other authors have no financial conflicts to disclose.
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Kim, G., Deepinder, F., Morales, W. et al. Methanobrevibacter smithii Is the Predominant Methanogen in Patients with Constipation-Predominant IBS and Methane on Breath. Dig Dis Sci 57, 3213–3218 (2012). https://doi.org/10.1007/s10620-012-2197-1
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DOI: https://doi.org/10.1007/s10620-012-2197-1