title: Impaired hydrogen metabolism in pneumatosis cystoides intestinalis.
abstract: BACKGROUND
  Pneumatosis cystoides intestinalis (PCI) is characterized by high levels of breath hydrogen. Clinical features of PCI may be due to abnormal H2 metabolism.
  
  
  METHODS
  Breath levels of H2 and CH4 were measured in 3 patients and total gas in 2 patients with PCI on a polysaccharide-free (basal) diet and after administration of 15 g of lactulose. Metabolic activities and counts of methanogenic (MB) and sulfate-reducing (SRB) bacteria were measured in feces. Ten volunteers were also studied.
  
  
  RESULTS
  Total H2 levels in patients were 383-420 mL/day on the basal diet and 1430-1730 mL/day after lactulose administration compared with 35 +/- 6 mL/day and 262 +/- 65 mL/day, respectively, in controls. Basal breath H2 levels in controls were 27 +/- 6 vs. 214 +/- 27 mL/day in patients and after lactulose ingestion, 115 +/- 18 vs. 370 +/- 72 mL/day. Four controls were methanogenic and had high fecal MB counts. The other controls had high SRB counts and sulfate reduction rates. All patients were nonmethanogenic and had low sulfate reduction rates.
  
  
  CONCLUSIONS
  Patients with PCI excrete more H2 than controls. In normal subjects, H2 is consumed by MB or SRB; the activity of these bacteria is virtually absent in PCI. This may explain the gas accumulation in these patients.
authors.affiliation: Medical Research Council Dunn Clinical Nutrition Centre, Cambridge, England.
authors.forename: S U
authors.initials: SU
authors.lastname: Christl
authors.forename: G R
authors.initials: GR
authors.lastname: Gibson
authors.forename: P R
authors.initials: PR
authors.lastname: Murgatroyd
authors.forename: W
authors.initials: W
authors.lastname: Scheppach
authors.forename: J H
authors.initials: JH
authors.lastname: Cummings
mesh_terms: D000328:Adult; D001419:Bacteria / Q000378:metabolism; D005243:Feces / Q000382:microbiology; D006801:Humans; D006859:Hydrogen / Q000378:metabolism*; D008297:Male; D008697:Methane / Q000378:metabolism; D008875:Middle Aged; D011006:Pneumatosis Cystoides Intestinalis / Q000378:metabolism* / Q000382:microbiology; D013431:Sulfates / Q000378:metabolism
chemical_list: D013431:Sulfates; D006859:Hydrogen; D008697:Methane