Original ArticleBacterial Overgrowth and Methane Production in Children with Encopresis
Section snippets
Methods
The study was conducted at the Gastroenterology and Nutrition Outpatient Clinic of the Alfred I. duPont Hospital for Children in Wilmington, DE, from January 2005 to June 2008. The study enrolled otherwise healthy school age children (6 to 12 years) with normal general intellectual functioning who had a history and physical examination consistent with secondary retentive encopresis. All patients had daily or weekly episodes of fecal soiling for a minimum of 2 months before evaluation. Patients
Results
The mean fecal impaction (FI) radiographic score was 1.9 ± 0.65 for the entire encopretic group. There was a significant difference (P < .01) in the mean FI score between methane producers (2.03 ± 0.32; n = 24) and non-methane–producing patients (1.72 ± 0.44; n = 26). The mean FI scores of the SIBO-positive patients (1.9 ± 0.49) and the SIBO-negative patients (1.89 ± 0.39) were not different (P = .06).
SIBO was found in 21 of the 50 (42%) children with encopresis. The prevalence of SIBO was
Discussion
Because the bacterial flora in the small intestine is controlled by motility and methane production is associated with slower motility, patients with encopresis and methane production are at risk for SIBO. We hypothesized that methane production increases the risk for SIBO by slowing small intestinal transit time. SIBO was diagnosed more frequently in our patients with encopresis compared with the children with other gastrointestinal disorders, but this did not reach significance (P = .06).
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Funding for the project was obtained through the Nemours Foundation. The authors declare no conflicts of interest.