The importance of methane breath testing: a review.

@article{deLacyCostello2013TheIO,
  title={The importance of methane breath testing: a review.},
  author={Ben de Lacy Costello and Maximilian Ledochowski and Norman Ratcliffe},
  journal={Journal of breath research},
  year={2013},
  volume={7 2},
  pages={
          024001
        }
}
Sugar malabsorption in the bowel can lead to bloating, cramps, diarrhea and other symptoms of irritable bowel syndrome as well as affecting absorption of other nutrients. The hydrogen breath test is now a well established noninvasive test for assessing malabsorption of sugars in the small intestine. However, there are patients who can suffer from the same spectrum of malabsorption issues but who produce little or no hydrogen, instead producing relatively large amounts of methane. These patients… 
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References

SHOWING 1-10 OF 90 REFERENCES
Methane Production During Lactulose Breath Test Is Associated with Gastrointestinal Disease Presentation
TLDR
A methane positive breath test is associated with constipation as a symptom in IBS and IBD and was almost nonexistent in the predominantly diarrheal conditions of Crohn's and UC.
Small intestine bacterial overgrowth is frequent in cystic fibrosis: combined hydrogen and methane measurements are required for its detection.
TLDR
Combined hydrogen and methane measurement instead of hydrogen breath test should be applied for its detection in cystic fibrosis and other gastrointestinal patients because without the additional measurement of methane a significant percentage of SIBO will be missed.
Breath testing in intestinal disaccharidase deficiency and bacterial overgrowth of the small intestine
TLDR
Measurement of hydrogen and methane levels in alveolar samples collected following a carbohydrate challenge is simple, non-invasive and provides good sensitivity and specificity.
Methane excretion in man--a study of breath, flatus, and faeces.
TLDR
The results indicate that different gastrointestinal patient groups have different prevalences of breath methane excretion and that all healthy subjects may produce methane but only when the production reaches a threshold does it appear in the breath.
Reassessment of the role of methane production between irritable bowel syndrome and functional constipation.
TLDR
Methane excretion is clearly associated with alterations in intestinal motility, particularly favouring those with constipation, and appears to be an appropriate term to define "methane-producers".
Detection of Bacterial Overgrowth in IBS Using the Lactulose H2 Breath Test: Comparison with 14C-d-Xylose and Healthy Controls
TLDR
The lactulose breath test did not reliably detect a common association between bacterial overgrowth and IBS in the patient population of Rome II positive IBS patients and compared it to the 14C-d-xylose Breath test, a test with acknowledged greater specificity for bacterial over growth.
Methane and the Gastrointestinal Tract
TLDR
There is increasing evidence that this gas has both physical and biological effects on gut function, and it is now often associated with functional constipation and may have an active role here.
The possible role of breath methane measurement in detecting carbohydrate malabsorption.
TLDR
Data suggested that in methanogenic individuals, breath CH4 measurement might enhance the accuracy of H2 breath testing in detecting carbohydrate malabsorption.
Combined oro-caecal scintigraphy and lactulose hydrogen breath testing demonstrate that breath testing detects oro-caecal transit, not small intestinal bacterial overgrowth in patients with IBS
TLDR
It is demonstrated that an abnormal rise in H2 measured in the LHBT can be explained by variations in oro-caecal transit time in patients with IBS and therefore do not support the diagnosis of SIBO.
Measurement of breath hydrogen and methane, together with lactase genotype, defines the current best practice for investigation of lactose sensitivity
TLDR
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%.
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