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World J Gastroenterol. May 21, 2006; 12(19): 3088-3091
Published online May 21, 2006. doi: 10.3748/wjg.v12.i19.3088
Hydrogen and methane gases are frequently detected in the stomach
Yoshihisa Urita, Susumu Ishihara, Tatsuo Akimoto, Hiroto Kato, Noriko Hara, Yoshiko Honda, Yoko Nagai, Kazushige Nakanishi, Nagato Shimada, Motonobu Sugimoto, Kazumasa Miki
Yoshihisa Urita, Susumu Ishihara, Tatsuo Akimoto, Hiroto Kato, Noriko Hara, Yoshiko Honda, Yoko Nagai, Kazushige Nakanishi, Nagato Shimada, Motonobu Sugimoto, Department of General Medicine and Emergency Care, Toho University School of Medicine, Omori Hospital, Tokyo, Japan
Kazumasa Miki, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University School of Medicine, Omori Hospital, Tokyo, Japan
Kazumasa Miki, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University School of Medicine, Omori Hospital, 6-11-1, Omori-Nishi, Ota-Ku, Tokyo 143-8541, Japan. foo@eb.mbn.or.jp
Author contributions: All authors contributed equally to the work
Correspondence to: Yoshihisa Urita, Department of General Medicine and Emergency Care, Toho University School of Medicine, Omori Hospital, Tokyo, Japan
Telephone: +81-3-37624151 Fax: +81-3-37656518
Received: December 12, 2005
Revised: January 11, 2006
Accepted: January 14, 2006
Published online: May 21, 2006
Abstract

AIM: 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.

CONCLUSION: 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.

Keywords: Intragastric gases; Hydrogen; Methane; Helicobacter pylori