Effect of predominant methanogenic flora on the outcome of lactose breath test in irritable bowel syndrome patients

Vernia, Piero; Camillo, Mauro Di; Marinaro, Vanessa; Caprilli, R.

doi:10.1016/s1590-8658(01)80268-1

Cited by 12 publications

(15 citation statements)

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“…Measurement of both hydrogen and methane at 6 h considerably improved sensitivity, specificity and the predictive value in CT/GA-and TT/AA genotyped patients only (Table 1; Figures 1 and 2). 32 Of the total, 83.3% of CT/GA were classed as LS. Of these, 69.8% had high hydrogen and 28.3% high methane after challenge; 76.3% of TT/AA were classed as LS and 71.5% had increased hydrogen and 40% increased methane.…”

Section: Resultsmentioning

confidence: 99%

Measurement of breath hydrogen and methane, together with lactase genotype, defines the current best practice for investigation of lactose sensitivity

2008

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Background: Currently, there is no 'gold standard' for detecting patients with sensitivity to lactose. Biochemical investigation by a breath hydrogen test alone detects ,50% cases. Breath methane and symptoms are not recorded as standard practice. The clinical value of analysing C/T 13910 and G/A 22018 polymorphisms, strongly associated with lactose sensitivity, has not been established. Methods: Two hundred and ten patients with unexplained gut and systemic symptoms and controls were challenged with 50 g lactose. Breath hydrogen and methane were measured and symptoms recorded. All were genotyped for two polymorphisms, C/T 13910 and G/A 22018 . Results: CC 13910 /GG 22018 in 14.5%, CT 13910 /GA 22018 in 39% and TT 13910 /AA 22018 in 46.5%. One hundred percent of CC 13910 / GG 22018 were lactose sensitive having a breath hydrogen .20 ppm within 6 h and symptoms. But the breath hydrogen test lacked sensitivity and specificity in the other groups. There was elevated breath hydrogen in 21% of CT 13910 /GA 22018 and 15% of TT 13910 /AA 22018 by 6 h, whereas 17 and 30.9% had elevated breath methane alone. Breath methane and breath hydrogen with clinical symptoms improved sensitivity and specificity, increasing detection of lactose sensitivity in genotypes CT/GA and TT/AA from ,50 to .75%. Conclusions: The data presented define the current best practice for the clinical identification of lactose sensitivity. Patients were first genotyped. Those identified as CC with symptoms should immediately undertake a 12-week lactose-free diet. Those identified as CT or TT should undertake a breath hydrogen and methane test. Those positive for hydrogen or methane along with symptoms or with symptoms only, should also undertake a lactose-free diet. Those with high hydrogen without symptoms should be investigated for causes other than lactose sensitivity.

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Section: Resultsmentioning

confidence: 99%

Measurement of breath hydrogen and methane, together with lactase genotype, defines the current best practice for investigation of lactose sensitivity

2008

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“…Methane-producing bacteria utilise hydrogen for methane production and may therefore be associated with false negative hydrogen breath tests. 28 Methane-producing flora is especially important in constipation-predominant IBS patients. 29 We think that the results on treatment efficacy of rifaximin are not skewed as constipation-predominant IBS patients account for only 6% of the entire population.…”

Section: Discussionmentioning

confidence: 99%

Rifaximin treatment for the irritable bowel syndrome with a positive lactulose hydrogen breath test improves symptoms for at least 3 months

Meyrat

Safroneeva

Schoepfer

2012

Aliment Pharmacol Ther

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“…The intra-and intersubject variabilities are usually very large, and the interpretation of the results is often difficult. Methane producers may stop excreting, nonproducers may start to excrete methane, and occasionally the methane-producing status does not change after antibiotic treatments targeting the intestinal methanogenic flora [28][29][30]. Taken together, this suggests also that other, non-bacterial factors are also involved in the mechanism of gastrointestinal methane generation.…”

Section: Discussionmentioning

confidence: 99%

Hypoxia-Induced Generation of Methane in Mitochondria and Eukaryotic Cells - An Alternative Approach to Methanogenesis

Ghyczy¹,

Torday

Kaszaki

et al. 2008

Cell Physiol Biochem

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Background/Aims: Electrophilic methyl groups bound to positively charged nitrogen moieties may act as electron acceptors, and this mechanism could lead to the generation of methane from choline. The aims were to characterize the methanogenic potential of phosphatidylcholine metabolites, and to define the in vivo relevance of this pathway in hypoxia-induced cellular responses. Methods: The postulated reaction was investigated (1) in model chemical experiments, (2) in rat mitochondrial subfractions and (3) in bovine endothelial cell cultures under hypoxic conditions and in the presence of hydroxyl radical generation. The rate of methane formation was determined by gas chromatography with flame-ionisation detectors. The lucigenin-enhanced chemiluminescence assay was used to determine the reactive oxygen species-scavenging capacity of the choline metabolites. Results: Significant methane generation was demonstrated in all three series of experiments. Phosphatidylcholine metabolites with alcoholic moiety in the molecule (i.e. choline, N,N-dimethylethanolamine and N-methylethanolamine), inhibited oxygen radical production both in vitro and in vivo, and displayed an effectiveness proportional to the amount of methane generated and the number of methyl groups in the compounds. Conclusion: Methane generation occurs in aerobic systems. Phosphatidylcholine metabolites containing both electron donor and acceptor groups may have a function to counteract intracellular oxygen radical production.

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Effect of predominant methanogenic flora on the outcome of lactose breath test in irritable bowel syndrome patients

Cited by 12 publications

References 0 publications

Measurement of breath hydrogen and methane, together with lactase genotype, defines the current best practice for investigation of lactose sensitivity

Measurement of breath hydrogen and methane, together with lactase genotype, defines the current best practice for investigation of lactose sensitivity

Rifaximin treatment for the irritable bowel syndrome with a positive lactulose hydrogen breath test improves symptoms for at least 3 months

Hypoxia-Induced Generation of Methane in Mitochondria and Eukaryotic Cells - An Alternative Approach to Methanogenesis

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