The relationship of different variants of the course of small intestinal bacterial overgrowth with functional constipation in children

Relevance. Functional constipation (FC) is a common and urgent problem in pediatrics. The study of the effect of bacterial overgrowth syndrome (hydrogen–induced, H₂- and methanogenic, CH₄-SIBO) on the course of FC in children continues.

Purpose. To improve the quality of diagnostic and therapeutic approaches, evaluate the possible relationship between H₂- and SH₄-CIBR taking into account possible constipation in children.

Materials and methods. 82 patients were examined, including 33 patients with FC aged 8.0 [5.0:15.0] years, 15 (54.5 %) girls and 18 (45.5 %) boys, as well as 49 practically healthy children aged 9.0 [5.8:16.2] years, 27 (55.1 %) girls and 22 (44.9 %) boys. A standard clinical examination was performed. The determination of H₂- and CH₄-SIBO was performed using noninvasive methods: the «Lactofan» hydrogen breathing test (Russia) and the GastroCheckGastrolyzer hydrogen-methane test (UK). Statistical analysis is implemented in the StatTech program. v. 4.6.1 (Russia).

Results. SIBO of various types (31/93.9 % and 28/57.1 %, p<0.001) and H₂-SIBO (22/67.7 % and 18/36.7 %, p=0.008) were significantly more often detected in patients with FC than in the comparison group. The frequency of CH₄-SIBO (9/27.2 % and 10/20.4 %, p=0.47) did not significantly differ. In patients with FC, the concentration of H₂ (ppm) for 90 minutes. The respiratory rate was significantly higher than in the comparison group (42.09±29.85 and 15.08±12.69, p<0.001). A statistically significant correlation was obtained between the concentration of H₂ at 60 min (ρ=0.496, p=0.026) and 90 min studies (ρ=0.566, p=0.009) with the duration of the FC course, which reflects the increased metabolic activity of hydrogen-synthesizing microorganisms in the small intestine. There were no statistically significant correlations between the methane concentration and the duration of the FC (p>0.05).

Conclusions. The majority of patients with FC had small intestinal bacterial overgrowth (93.9 %). The shown correlation relationship, the regression dependence of H₂-SIBO with the duration of the course of FC, in the absence of such a relationship with the level of CH₄, dictates the need for respiratory diagnosis on SIBO and its further therapeutic correction.

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