Colonic concentrations of hydrogen and methane following colonoscopic preparation with an oral lavage solution

Explosions are a rare complication of electrocautery in the colon. The cause of these explosions is ignition of gas containing hydrogen (greater than 4%) or methane (greater than 5%), and oxygen. Hydrogen and methane are products of colonic bacterial metabolism. Oral solutions used for colonoscopy preparation are designed to cleanse the colonic lumen but provide no substrate for fermentation reactions. In 52 patients undergoing colonoscopy, gas samples were collected from the right, transverse, and left colon and analyzed for hydrogen, methane, oxygen, and carbon dioxide. The highest hydrogen and methane concentrations were 0.6% and 0.7%, respectively, less than 16% of the explosive level. Oxygen and carbon dioxide concentrations were close to those of air, suggesting that the bulk of colonic gas was air infused during the procedure. We conclude that the concentrations of explosive gases are well below the hazardous levels when oral colonic cleansing solutions and standard colonoscopic procedures are employed.