Document Detail

Do interventions which reduce colonic bacterial fermentation improve symptoms of irritable bowel syndrome?
MedLine Citation:
PMID:  15844715     Owner:  NLM     Status:  MEDLINE    
Abnormal fermentation may be an important factor in irritable bowel syndrome (IBS). Gastroenteritis or antibiotic therapy may damage the colonic microflora, leading to increased fermentation and the accumulation of gas. Gas excretion may be measured by whole-body calorimetry but there has only been one such study on IBS to date. We aimed to assess the relationship between IBS symptoms and fermentation rates in IBS. A purpose-built, 1.4-m3, whole-body calorimeter was used to assess excretion of H2 and CH4 in IBS subjects while consuming a standard diet and, again, after open randomization on either the standard diet together with the antibiotic metronidazole or a fiber-free diet to reduce fermentation. Metronidazole significantly reduced the 24-hr excretion of hydrogen (median value compared to the control group, 397 vs 230 ml/24 hr) and total gas (H2 + CH4; 671 vs 422 ml/min) and the maximum rate of gas excretion (1.6 vs 0.8 ml/min), as did a no-fiber polymeric diet (hydrogen, 418 vs 176 ml/min; total gas, 564 vs 205 ml/min; maximum rate of gas excretion, 1.35 vs 0.45 ml/min), with a significant improvement in abdominal symptoms. IBS may be associated with rapid excretion of gaseous products of fermentation, whose reduction may improve symptoms.
Keith L E Dear; Marinos Elia; John O Hunter
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  50     ISSN:  0163-2116     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-04-22     Completed Date:  2005-05-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  758-66     Citation Subset:  AIM; IM    
Department of Gastroenterology, Addenbrooke's Hospital NHS Trust, Cambridge, UK.
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MeSH Terms
Anti-Infective Agents / therapeutic use*
Bacteria / metabolism*
Breath Tests
Circadian Rhythm
Colon / microbiology*
Colony Count, Microbial
Dietary Fiber / administration & dosage*
Gases / metabolism
Gastrointestinal Transit
Hydrogen / metabolism
Irritable Bowel Syndrome / microbiology,  physiopathology,  therapy*
Metronidazole / therapeutic use*
Treatment Outcome
Reg. No./Substance:
0/Anti-Infective Agents; 0/Gases; 1333-74-0/Hydrogen; 443-48-1/Metronidazole; 4618-18-2/Lactulose

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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