Evaluation of an extremely flatulent patient: Case report and proposed diagnostic and therapeutic approach

@article{Levitt1998EvaluationOA,
  title={Evaluation of an extremely flatulent patient: Case report and proposed diagnostic and therapeutic approach},
  author={Michael D. Levitt and Julie K. Furne and M. R. Aeolus and Fabrizis L. Suarez},
  journal={American Journal of Gastroenterology},
  year={1998},
  volume={93},
  pages={2276-2281}
}
We recently encountered a patient with severe flatulence who previously had been subjected to innumerable diagnostic tests and ineffective therapies based on the belief that his rectal gas was produced in the colon. Analysis of three flatus samples demonstrated that nitrogen (N2) was the predominant flatus gas whereas the three gases produced in the gut (CO2, H2 [hydrogen], and CH4 [methane]) comprised <16% of rectal gas. This result plus a series of other diagnostic tests clearly indicated… 

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References

SHOWING 1-10 OF 18 REFERENCES

The Relation of Passage of Gas and Abdominal Bloating to Colonic Gas Production

The results show that symptoms commonly attributed to excess intestinal gas do not necessarily reflect increased gas production and the influence of the fiber preparations on breath hydrogen excretion in five participants.

Investigation of normal flatus production in healthy volunteers.

Flatulence can cause discomfort and distress but there are few published data of normal patterns and volumes. Twenty four hour collections were made using a rectal catheter in 10 normal volunteers

Studies of a flatulent patient.

The physician seldom deals rationally with a patient complaining of excessive flatus, and evaluation usually conspires to underestimate the severity of the problem.

Alterations of the colonic flora and their effect on the hydrogen breath test.

The hydrogen production was very markedly depressed after preparation for colonscopy and antibiotic therapy, and the effect of neomycin and enemata as used in preparation for colon surgery was less marked.

Insights into human colonic physiology obtained from the study of flatus composition.

Analysis of flatus composition provides a novel means of assessing colonic physiology, particularly ongoing bacterial metabolism throughout the unperturbed colon, and suggests coexistence of both organisms in the colon.

Gases produced by Human Intestinal Microflora

It is shown that egestion as flatus of gaseous nitrogen produced in the intestine is not normally an important route of nitrogen loss and might account for reports of prolonged positive nitrogen balance in adult man and animals in the absence of commensurate growth.

Colonic adaptation to daily lactose feeding in lactose maldigesters reduces lactose intolerance.

There is colonic adaptation to regular lactose ingestion and this adaptation reduces lactose intolerance symptoms, and the sum of hourly breath-hydrogen concentrations was significantly reduced after the lactose feeding period compared with after the dextrose period.

Absence of gaseous symptoms during ingestion of commercial fibre preparations

Gaseous complaints during fibre ingestion were assessed in subjects who believed that a previous exposure to fibre induced gas.

Fecal Hydrogen Sulfide Production in Ulcerative Colitis

Increased H2S release is a relatively localized metabolic aberration of ulcerative colitis feces that may reflect abnormalities of the fecal bacteria and/or substrate availability, and organic compounds provided more readily utilizable substrate for H 2S production than did sulfate.