Extensive Atrophic Gastritis Increases Intraduodenal Hydrogen Gas

Author:

Urita Yoshihisa1,Watanabe Toshiyasu2,Maeda Tadashi1,Arita Tomohiro1,Sasaki Yosuke1,Ishii Takamasa1,Yamamoto Tatsuhiro1,Kugahara Akiro1,Nakayama Asuka1,Nanami Makie1,Domon Kaoru3,Ishihara Susumu2,Kato Hirohito4,Hike Kazuo4,Hara Norikok4,Watanabe Shuji4,Nakanishi Kazushige1,Sugimoto Motonobu1,Miki Kazumasa3

Affiliation:

1. Department of General Medicine and Emergency Care, School of Medicine, Toho University, Omori Hospital, Tokyo 143-8541, Japan

2. Department of Hematology, School of Medicine, Toho University, Omori Hospital, Tokyo 143-8541, Japan

3. Division of Gastroenterology and Hepatology, School of Medicine, Toho University, Omori Hospital, Tokyo 143-8541, Japan

4. Department of Internal Medicine, School of Medicine, Toho University, Omori Hospital, Tokyo 143-8541, Japan

Abstract

Objective. Gastric acid plays an important part in the prevention of bacterial colonization of the gastrointestinal tract. If these bacteria have an ability of hydrogen (H2) fermentation, intraluminal H2 gas might be detected. We attempted to measure the intraluminal H2 concentrations to determine the bacterial overgrowth in the gastrointestinal tract.Patients and methods. Studies were performed in 647 consecutive patients undergoing upper endoscopy. At the time of endoscopic examination, we intubated the stomach and the descending part of the duodenum without inflation by air, and 20 mL of intraluminal gas samples of both sites was collected through the biopsy channel. Intraluminal H2 concentrations were measured by gas chromatography.Results. Intragastric and intraduodenal H2 gas was detected in 566 (87.5%) and 524 (81.0%) patients, respectively. The mean values of intragastric and intraduodenal H2 gas were8.5±15.9and13.2±58.0 ppm, respectively. The intraduodenal H2 level was increased with the progression of atrophic gastritis, whereas the intragastric H2 level was the highest in patients without atrophic gastritis.Conclusions. The intraduodenal hydrogen levels were increased with the progression of atrophic gastritis. It is likely that the influence of hypochlorhydria on bacterial overgrowth in the proximal small intestine is more pronounced, compared to that in the stomach.

Publisher

Hindawi Limited

Subject

Gastroenterology,Hepatology

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