[Endoscopic intragastric detection of hydrogen]

The sensitivity of hydrogen (H2) breath-tests for testing small-intestinal bacterial overgrowth is limited by many factors. In this study H2 was tested directly with a selective electrochemical cell in a sample of stomach gas obtained during gastroscopy. This was possible in 100 of 109 cases. In patients with dyspeptic disorders (complaints of excess gas) H2 concentrations were significantly higher than in the group of patients without these complaints (p less than 0.001). In dyspepsia the stomach-test was significantly more often pathological than H2-breath-test with glucose (p = 0.01). There was no correlation between the results of both tests in 66 cases. Intragastral H2 may result from H2-reflux from the small bowel, because there was no difference in bacterial growth in gastric and duodenal juice and in gastric mucosa of patients with high and normal H2 concentrations in the stomach and because a motility disturbance of upper GI-tract (prolonged gastric emptying time) correlated well with H2-concentrations (p less than 0.05). PH of gastric contents, various ingested dietary substrates, smoking, endoscopic and histological diagnosis did not influence ig H2. Measurement of H2 during gastroscopy may give immediate evidence of small bowel motility-disorders.