J.Jpn. Surg. Soc.. 58(11): 1691-1717, 1958

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EXPERIMENTAL AND CLINICAL STUDIES ON THE INTESTINAL GAS

The intestinal gas obtained on laparotomy of 216 patient with disorders of various abdominal organs were analysed by means of the Haldane's method with respect to the volume and nature of constituent gases. In addition, the changes of gas composition in the intestinal loop exposed out of abdominal cavity in cases of artificial anus, were also observed. In dogs fed with controlled diet, gas composition was analysed, both in normal and ileus cases. The results are summarized as follows:
1) Decomposition of intestinal contents, diffusion of blood gases into the intestinal lumen, inhibition of the gas absorption and ingestion of air were contributory as the source of intestinal gas and the cause of its increase. The first two factors are more significant among them.
2) The composition of intestinal gas were H₂S, CO₂, O₂, CH₄, H₂, and N₂ gases. It seems that the decomposition of intestinal dietary contents resulted in the formation of H₂S, CH₄, H₂ and CO₂ gases.
3) The volume of solid dietary contents in the intestine has a close relationship with the amount of gas formed and also with the composition of the intestinal gas. Larger amount of this dietary contents tend to produce more intestinal gas.
4) Circulatory distulbance of the intestinal wall significantly affect the volume and composition of the gas accumulated due to the inhibition of the gas absorption from the intestinal wall, which eventually results in the increase of gas formed due to the decomposition of the dietary contents. This was well demonstrated in acute intestinal obstruction and acute peritonitis which impair the intestinal circulation. In chronic obstruction of the bowel, on the other hand, the intestinal circulation, i. e., the absorption is well maintained and accordingly the volume of the gas due to decomposition was lesser.
5) N₂ gas tends to exist in larger amount at the distal portion of the small intestine and seems to diffuse from blood through the intestinal wall.
6) In the normal case, contrary to the former concept that the gas formation due to, the decomposition is limited to occur only in the large intestine, the gas formation occurs also at the upper portion of the small intestine, but, of course, more conspicuously at the distal portion.
7) There was found a larger amount of stagnant gas in the lumen of the large bowel than of the small bowel.
In a state of the colonic obstruction, a relatively large amount of gas due to the decomposition was found.
8) In cases of acute intestinal obstruction and acute peritonitis, while the meteorism increased with the elapse of time, the volume of the intestinal gas also increased. The rate of gas due to the decomposition was greatly augmented.
9) O₂ gas present in the intestinal lumen has its origin in the diffused gas from blood and in part in the air swallowed. It was gradually absorbed as the intestinal contents were propelled downward along the intestinal lumen.
10) The hydrocarbonate-diet produced relatively large amount of the intestinal gas, especially of H₂. The protein-diet produced relatively large amount of CO₂ and H₂S. The: fat-diet formed a small amount of gas showing relative increase of H₂S and CO₂.
(author's abstract)

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