Fig. 2. Comparison of volume passing through the digestive tract between gas and liquid plus solid contents.
Diverticulosis
High methanogen concentrations were found in patients with diverticulosis [29]. This suggests that the diverticula may provide an optimal environment for the growth of methanogens. It is possible that the diverticula may provide a sheltered niche where the slow-growing methanogens are not swept away and where symbiotic relationships with H2-producing organisms may occur. Since CH4 production occurs mainly in the left colon, H2 produced in the left colon may be rapidly converted to CH4, possibly resulting in reduced flatus.
Table 1. Direction of diffusion of gas between the lumen and mucosal blood
Conclusions
The sources of intraluminal gas are air swallowing, intraluminal production, and diffusion from the blood. Five gases (N2, O2, CO2, H2, and CH4) account for more than 99% of gas passed per rectum. As shown in figure 2, greater amount of gases pass through the digestive tract per day than liquid and solid contents. There are geographical differences in gas metabolism (table 1). This suggests that impaired gas movement might be more closely associated with abdominal symptoms compared to liquid movement. Although it is unknown if increased and unequally distributed gases in the digestive tract are the key event in the pathogenesis of abdominal symptoms, intestinal gas metabolism might be one of the risk factors for developing various digestive diseases.
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