Hydrogen and methane gases are frequently detected in the stomach.
OBJECTIVE
To investigate the incidence of bacterial overgrowth in the stomach by using a new endoscopic method in which intragastric hydrogen and methane gases are collected and analyzed.


METHODS
Studies were performed in 490 consecutive patients undergoing esophagogastroscopy. At endoscopy, we intubated the stomach without inflation by air, and 20 mL of intragastric gas was collected through the biopsy channel using a 30 mL syringe. Intragastric hydrogen and methane concentrations were immediately measured by gaschromatography. H pylori infection was also determined by serology.


RESULTS
Most of intragastric hydrogen and methane levels were less than 15 ppm (parts per million). The median hydrogen and methane values (interquartile range) were 3 (1-8) ppm and 2 (1-5) ppm, respectively. The high hydrogen and methane levels for indication of fermentation were decided if the patient had the values more than 90 percentile range in each sample. When a patient had a high level of hydrogen or methane in one or more samples, the patient was considered to have fermentation. The overall incidence of intragastric fermentation was 15.4% (73/473). Intragastric methane levels were higher in the postoperative group than in other groups. None of the mean hydrogen or methane values was related to H pylori infection.


CONCLUSIONS
Hydrogen and methane gases are more frequently detected in the stomach than expected, regardless of the presence of abdominal symptoms. Previous gastric surgery influences on the growth of methane-producing bacteria in the fasting stomach.
Urita
Yoshihisa
Y
Department of General Medicine and Emergency Care, Toho University School of Medicine, Omori Hospital, Tokyo, Japan.
Ishihara
Susumu
S
Akimoto
Tatsuo
T
Kato
Hiroto
H
Hara
Noriko
N
Honda
Yoshiko
Y
Nagai
Yoko
Y
Nakanishi
Kazushige
K
Shimada
Nagato
N
Sugimoto
Motonobu
M
Miki
Kazumasa
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002849:Chromatography, Gas; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005740:Gases; D016480:Helicobacter pylori / Q000378:metabolism; D006801:Humans; D006859:Hydrogen / Q000032:analysis* / Q000378:metabolism; D015994:Incidence; D008297:Male; D008697:Methane / Q000032:analysis* / Q000378:metabolism; D008875:Middle Aged; D010437:Peptic Ulcer / Q000378:metabolism; D013270:Stomach / Q000737:chemistry* / Q000382:microbiology / Q000601:surgery
D005740:Gases; D006859:Hydrogen; D008697:Methane