Brief Article
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World J Gastroenterol. Nov 7, 2012; 18(41): 5932-5939
Published online Nov 7, 2012. doi: 10.3748/wjg.v18.i41.5932
Methane production and small intestinal bacterial overgrowth in children living in a slum
Carolina Santos Mello, Soraia Tahan, Lígia Cristina FL Melli, Mirian Silva do Carmo Rodrigues, Ricardo Martin Pereira de Mello, Isabel Cristina Affonso Scaletsky, Mauro Batista de Morais
Carolina Santos Mello, Soraia Tahan, Lígia Cristina FL Melli, Ricardo Martin Pereira de Mello, Mauro Batista de Morais, Pediatric Gastroenterology Division, Federal University of Sao Paulo, 04039-031 Sao Paulo, Brazil
Carolina Santos Mello, Lígia Cristina FL Melli, Mirian Silva do Carmo Rodrigues, Center Foundation Institute of Education for Osasco, 06020-190 Sao Paulo, Brazil
Mirian Silva do Carmo Rodrigues, Infectology Division, Federal University of Sao Paulo, 04025-010 Sao Paulo, Brazil
Isabel Cristina Affonso Scaletsky, Microbiology, Immunology and Parasitology Division, Federal University of Sao Paulo, 04023-062 Sao Paulo, Brazil
Author contributions: Mello CS, Tahan S, Melli LCFL, Carmo-Rodrigues MS, Mello RMP, Scaletsky ICA, Morais MB contributed equally to this work.
Supported by Coordination for the Improvement of Higher Education Personnel (CAPES) and Food and Nutrition Fund-Municipal Health Fund of Osasco, Sao Paulo, Brazil
Correspondence to: Mauro Batista de Morais, MD, PhD, Pediatric Gastroenterology Division, Federal University of Sao Paulo, 441 Pedro de Toledo st, 04039-031 Sao Paulo, Brazil. mbmorais@osite.com.br
Telephone: +55-11-55795834 Fax: +55-11-55391097
Received: January 24, 2012
Revised: March 30, 2012
Accepted: April 13, 2012
Published online: November 7, 2012
Abstract

AIM: To analyze small intestinal bacterial overgrowth in school-aged children and the relationship between hydrogen and methane production in breath tests.

METHODS: This transversal study included 85 children residing in a slum and 43 children from a private school, all aged between 6 and 10 years, in Osasco, Brazil. For characterization of the groups, data regarding the socioeconomic status and basic housing sanitary conditions were collected. Anthropometric data was obtained in children from both groups. All children completed the hydrogen (H2) and methane (CH4) breath test in order to assess small intestinal bacterial overgrowth (SIBO). SIBO was diagnosed when there was an increase in H2≥ 20 ppm or CH4≥ 10 ppm with regard to the fasting value until 60 min after lactulose ingestion.

RESULTS: Children from the slum group had worse living conditions and lower nutritional indices than children from the private school. SIBO was found in 30.9% (26/84) of the children from the slum group and in 2.4% (1/41) from the private school group (P = 0.0007). Greater hydrogen production in the small intestine was observed in children from the slum group when compared to children from the private school (P = 0.007). A higher concentration of hydrogen in the small intestine (P < 0.001) and in the colon (P < 0.001) was observed among the children from the slum group with SIBO when compared to children from the slum group without SIBO. Methane production was observed in 63.1% (53/84) of the children from the slum group and in 19.5% (8/41) of the children from the private school group (P < 0.0001). Methane production was observed in 38/58 (65.5%) of the children without SIBO and in 15/26 (57.7%) of the children with SIBO from the slum. Colonic production of hydrogen was lower in methane-producing children (P = 0.017).

CONCLUSION: Children who live in inadequate environmental conditions are at risk of bacterial overgrowth and methane production. Hydrogen is a substrate for methane production in the colon.

Keywords: Bacterial overgrowth; Breath test; Children; Colon; Hydrogen; Methane; Small intestine