Homemade Elemental Diet to Treat Intestinal Methanogen Overgrowth: A Case Report.

introductionThis case report documented the outcome of consuming a 14-day homemade elemental diet to normalize intestinal methanogen overgrowth. A prevention protocol after methanogen eradication was employed to prevent recurrence. PRESENTING CONCERNS: The patient was a 47-year-old White female with intestinal methanogen overgrowth confirmed by lactulose breath testing. THERAPEUTIC FOCUS AND ASSESSMENT: Therapeutic interventions consisted of the homemade elemental diet, carbohydrate modified diet, lifestyle modifications, pharmaceutical and herbal prokinetics, and a probiotic supplement. FOLLOW-UP AND OUTCOMES: The homemade elemental diet was conducted for 14 days. The lactulose breath test results on day 15 indicated a reduction of methane levels from an average of 42 ppm to 3 ppm throughout the testing period (120 minutes). The standard prevention protocol of prokinetics, diet, and lifestyle were not effective at preventing relapse. A repeat lactulose breath test on day 122 was positive, with an average of 81 ppm methane. The elemental diet was repeated for 9 days, with fasting on day 10. The lactulose breath test on day 11 indicated a reduction of methane gas to an average of 23 ppm.

conclusionThe homemade elemental diet resulted in a substantial reduction in methane and symptom resolution. It is another treatment option for patients with intestinal methanogen overgrowth.