Scientists have discovered that a microorganism may be causing digestive problems in some people, potentially paving the way for better treatments for constipation.
Analyzing data from more than 1,500 people, researchers at the Cedars-Sinai Medical Center found that participants with an overgrowth of archaea in the gut—a type of microorganism that produces methane—were more likely to experience constipation.
Those with intestinal methanogen overgrowth (IMO)—too many archaea in the gut—could benefit from a personalized treatment plan to address the root cause of their symptoms, scientists concluded in a new study.
"The goal is to move toward developing specific therapies and personalized treatment for a subgroup of people who experience constipation due to IMO," Dr. Ali Rezaie, medical director of the Cedars-Sinai GI Motility Program and one of the study authors, said in a statement.
Constipation is very common in the U.S., affecting about 16 percent of adults and three in 10 people over 60, according to the study. Symptoms including bloating, abdominal pain and difficulty having bowel movements.
Many things can cause constipation, including a lack of fiber in the diet, a sedentary lifestyle, the side effects of medication, sleep disruption or stress.
An imbalance of microorganisms in the gut can also result in symptoms such as constipation, as this study shows.
The gut microbiome is a community of microorganisms, including bacteria and yeasts, that live in the digestive system and help the body digest food and absorb nutrients, among other functions.
A healthy gut microbiome is believed to be characterized by a richness and diversity of microorganisms—but if one strain becomes dominant, this imbalance can lead to disrupted digestion and symptoms such as constipation or diarrhea.
Constipation is commonly treated with laxatives—but taking laxatives may get the digestive system moving again without treating the root cause of digestive problems.
In some cases, laxatives could fail to affect, or even worsen, coexisting symptoms, such as diarrhea and bloating.
But with this discovery, there may be treatment options in future for those whose constipation is related to an overgrowth of archaea in the gut microbiome.
"Our study found that patients with IMO are more likely to have constipation, particularly severe constipation, and less likely to have unyielding diarrhea," said Rezaie. "Patients, however, also reported several other gut-related symptoms, including bloating, diarrhea, abdominal pain and flatulence."
Specifically, the results of the systematic review suggested that IMO patients were likely to experience bloating (78 percent), constipation (51 percent), abdominal pain (65 percent) and flatulence (56 percent).
Some of the subjects with IMO did experience other symptoms, such as diarrhea and nausea, but these were less likely.
Also, IMO was associated with more severe constipation, and less severe diarrhea, than the study's controls.
The condition could be diagnosed relatively easily, with a simple breath test to measure methane.
"When there is an excessive amount of archaea in your gut, they produce more methane, and some of that methane makes its way to your bloodstream, then to your lungs, and you breathe it out, where it can measured as a diagnostic test," said Rezaie.
Patients could then follow a treatment plan to suppress the growth of archaea in the gut, with antibiotics and a specialized diet.
"We can start by using breath tests to identify excessive methane production, which can be the first step to detecting archaea overgrowth and could ultimately lead to developing more targeted therapies. It's a big step to move away from the common reflex use of laxatives," said Rezaie.
He said in a statement that this research was crucial, and that he hoped it would encourage healthcare providers to utilize precision medicine, conduct clinical trials that target microbiome research, and develop strategies to optimize patient care.
"Historically there has been a paucity of information regarding the role of archaea in health and disease," Dr. Peter Chen, the interim chair of the Department of Medicine at Cedars-Sinai, said in a statement.
"Unique symptom patterns related to IMO should be taken into account when measuring patient-reported outcomes and should be further studied in relation to the microbiome."
Thomas Idris Marquand is an earth scientist at the University of Cambridge whose research has involved investigating methane in the breath.
"I'm not looking at overgrowth of methanogens, just whether they are present," he told Newsweek. "People who report no gastrointestinal symptoms may well have elevated breath methane without even knowing.
"In fact, it seems that around 20 to 40 percent of people have this extra methane in their breath and some don't.
"We can be confident that it's all about the gut microbiome. Methanogens are archaea (not bacteria, which is a common mistake people make), which we know are present in some people's guts and not others.
"It is likely that we acquire methanogens—or don't as the case may be—in the same way we acquire the rest of our gut microbiome—from our parents, food and environment—and that methanogens in the gut will respond to similar stressors as the rest of the gut microbiome: medication, infection, immune response, dietary changes, etc.
"Currently we don't have strong evidence linking the presence or absence of elevated breath methane to dietary or lifestyle factors, but watch this space!"
Marquand also said that the link these researchers had found between constipation and methanogen overgrowth was "compelling" and "totally logical," but the differences they found between the two groups were "not very large," so further research would have to be done to confirm the link.
This systematic review included 19 studies and was published in the scientific journal Clinical Gastroenterology and Hepatology last month.
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Reference
Mehravar, S., Takakura, W., Wang, J., Pimentel, M., Nasser, J., Rezaie, A. (2024). Symptom profile of patients with intestinal methanogen overgrowth: A systematic review and meta-analysis, Clinical Gastroenterology and Hepatology. https://doi.org/10.1016/j.cgh.2024.07.020
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