title: High incidence of fermentation in the digestive tract in patients with reflux oesophagitis.
abstract: OBJECTIVE
  Because bacteria represent the sole source of gut hydrogen (H2) and methane (CH4), fasting breath H2 and CH4 gases have been used as markers of colonic fermentation. The presence of carbohydrates in the colonic lumen inhibits gastric and pancreatic secretions, and also influences lower oesophageal sphincter function in gastro-oesophageal reflux disease.
  
  
  METHODS
  Studies were performed in 793 consecutive patients undergoing oesophagogastroscopy (270 men and 523 women, aged 19-85 years). A fasting breath sample (20 ml) was collected before endoscopy. At endoscopy, we intubated the stomach without inflation by air, and 20 ml of intragastric gas was collected through the biopsy channel. Next, the tip of the endoscope was inserted into the second portion of the duodenum without inflation by air, and 20 ml of intraduodenal gas was collected. H2 and CH4 concentrations of each sample were measured by gas chromatography.
  
  
  RESULTS
  Reflux oesophagitis was found in 147 of the 793 patients. The mean values of the H2 and/or CH4 levels of samples taken from the stomach, duodenum and exhaled air were higher in patients with reflux oesophagitis than those without reflux oesophagitis. High H2 and/or CH4 levels were more frequently found in patients with reflux oesophagitis.
  
  
  CONCLUSIONS
  We concluded that the presence of fermentation in the digestive tract was considered to be a risk factor for developing reflux oesophagitis.
authors.affiliation: Department of General Medicine and Emergency Care, Toho University School of Medicine, Omori Hospital, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo 143-8541, Japan. foo@eb.mbn.or.jp
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Urita
authors.forename: Motonobu
authors.initials: M
authors.lastname: Sugimoto
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hike
authors.forename: Naotaka
authors.initials: N
authors.lastname: Torii
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Kikuchi
authors.forename: Hidenori
authors.initials: H
authors.lastname: Kurakata
authors.forename: Eiko
authors.initials: E
authors.lastname: Kanda
authors.forename: Masahiko
authors.initials: M
authors.lastname: Sasajima
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Miki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001944:Breath Tests / Q000379:methods; D004064:Digestive System / Q000378:metabolism*; D004386:Duodenum / Q000378:metabolism; D004942:Esophagitis, Peptic / Q000378:metabolism*; D005260:Female; D005285:Fermentation / Q000502:physiology*; D005753:Gastric Mucosa / Q000378:metabolism; D006801:Humans; D006859:Hydrogen / Q000032:analysis; D008297:Male; D008697:Methane / Q000032:analysis; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D006859:Hydrogen; D008697:Methane