{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T04:58:07Z","timestamp":1785473887665,"version":"3.56.0"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Intestinal methanogen overgrowth (IMO) is defined by a single binary threshold of CH\n                      <jats:sub>4<\/jats:sub>\n                      \u2009\u2265\u200910\u2009ppm and is associated with slow transit constipation. We aimed to identify distinct breath methane trajectory phenotypes in patients with constipation and test their association with slow colonic transit.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed 188 adults with constipation who underwent glucose breath testing and colonic transit assessment. Group\u2010based trajectory modeling was used to classify CH\n                      <jats:sub>4<\/jats:sub>\n                      kinetics into phenotypes. Slow\u2010transit prevalence and diagnostic performance were compared across phenotypes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Results<\/jats:title>\n                    <jats:p>\n                      Sixty\u2010nine patients (36.7%) had slow colonic transit, and 61 (32.4%) met IMO criteria. Three CH\n                      <jats:sub>4<\/jats:sub>\n                      phenotypes were identified: High\u2010Producer (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200929, 15.4%; baseline CH\n                      <jats:sub>4<\/jats:sub>\n                      \u2009=\u200931\u2009ppm (median) with a rapid rise and sustained elevation), Low\u2010Producer (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200924, 12.8%; flat, CH\n                      <jats:sub>4<\/jats:sub>\n                      \u2009=\u200912\u2009ppm), and Non\u2010Producer (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009135, 71.8%; flat, CH\n                      <jats:sub>4<\/jats:sub>\n                      \u2009=\u20093\u2009ppm). Prevalence of slow transit differed across phenotypes (High\u2010Producer: 69.0%, Low\u2010Producer: 41.7%, Non\u2010Producer: 28.9%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). High\u2010Producer phenotype was independently associated with slow transit (aOR 5.67, 95% CI 2.22\u201314.50;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Among IMO\u2010positive patients, slow transit was more frequent in High\u2010Producer than others (69.0% vs. 40.6%; adjusted OR 3.98, 95% CI 1.27\u201313.95;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022). Compared with the IMO positives, High\u2010Producer pattern showed higher specificity (92.4% vs. 76.5%) and positive predictive value (69.0% vs. 54.1%) for slow transit.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      CH\n                      <jats:sub>4<\/jats:sub>\n                      trajectories identified distinct kinetic patterns in patients with chronic constipation. The High\u2010Producer phenotype was most strongly associated with slow colonic transit and offered higher specificity than the IMO threshold.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nmo.70409","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T03:49:14Z","timestamp":1785210554000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Methane Trajectory Phenotypes on Glucose Breath Testing Are Associated With Slow Colonic Transit: A Group\u2010Based Trajectory Modeling Analysis"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3628-4290","authenticated-orcid":false,"given":"Jarongkorn","family":"Sirimongkolkasem","sequence":"first","affiliation":[{"name":"Division of Gastroenterology &amp; Hepatology Stanford University  Palo Alto California USA"},{"name":"Department of Medicine, King Chulalongkorn Memorial Hospital and Center of Excellence in Neurogastroenterology and Motility Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8221-6626","authenticated-orcid":false,"given":"Briana","family":"Valencia","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology &amp; Hepatology Stanford University  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laren","family":"Becker","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology &amp; Hepatology Stanford University  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7328-5399","authenticated-orcid":false,"given":"Sean","family":"Spencer","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology &amp; Hepatology Stanford University  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6346-1627","authenticated-orcid":false,"given":"Irene","family":"Sonu","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology &amp; Hepatology Stanford University  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology &amp; Hepatology Stanford University  Palo Alto California USA"},{"name":"Hoag Digestive Health Institute  Newport Beach California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4153-5012","authenticated-orcid":false,"given":"Leila","family":"Neshatian","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology &amp; Hepatology Stanford University  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41575\u2010022\u201000673\u2010z"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2005.11.006"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41564\u2010024\u201001856\u2010x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.655"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0b013e32835eb916"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm.2014.20.1.31"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.5009\/gnl15588"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.00574.2004"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102022\u2010328166"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2017.46"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.06.090"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e3181c64c90"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.10.10.842"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/bf01647654"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2009.01.017"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2025.09.031"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13679"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.clinpsy.121208.131413"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v078.i02"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.14309\/ctg.0000000000000556"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2024.07.020"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.70211"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620\u2010024\u201008563\u2010x"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102982.2010.01517.x"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.14309\/ctg.0000000000000567"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000002279"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.70205"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/26345161251353437"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12568"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm.2011.17.2.185"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm22187"}],"container-title":["Neurogastroenterology &amp; 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