Breath hydrogen test after a bean meal demonstrates delayed oro-cecal transit time in children with chronic constipation

Objective: To evaluate oro-cecal transit time in children with chronic constipation. Methods: 34 patients with chronic functional constipation age 3 to 13 years and 15 controls without constipation. Oro-cecal transit time was evaluated using the hydrogen breath test after ingestion of lactulose and after a standard meal of cooked beans. Total and segmental colonic transit times were measured with radiopaque markers. Results: Of 34 patients with chronic constipation 61.8% had increased total colonic transit time (> 62 hours). Oro-cecal transit time measured with lactulose as substrate was similar (p = 0.727) in constipated patients with increased colonic transit time (63.8 +/- 16.3 minutes), in constipated patients with normal colonic transit time (66.9 +/- 22.9 minutes), and in controls (65.3 +/- 15.5 minutes). Using a test meal of beans, the hydrogen breath test showed that oro-cecal transit time of constipated patients with increased total colon transit time was higher (252.4 +/- 23.2 minutes) than oro-cecal transit time of constipated patients with normal colonic transit time (227.7 +/- 39.6 minutes) or controls (205.3 +/- 23.3 minutes) (p <.05). Conclusion: Hydrogen excretion in breath after a bean test meal showed delayed oro-cecal transit time in children with chronic constipation with abnormal total colonic transit time.