Perez Frederic, Accarino Anna, Azpiroz Fernando, Quiroga Sergi, Malagelada Juan-R
Digestive System Research Unit, University Hospital Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain.
Am J Gastroenterol. 2007 Apr;102(4):842-9. doi: 10.1111/j.1572-0241.2007.01071.x.
Patients frequently complain of gas symptoms precipitated by meals, but the effect of early digestion on intestinal gas content remains unknown. Our aim was to determine the influence of meals on intestinal gas volume and distribution.
First, we developed a CT image analysis program, based on independent software modules, to measure gas content within the gut. The system was validated in nine healthy subjects by taking helical abdominal CT scans before and after rectal infusion of known volumes of air (100-400 mL). In 15 healthy subjects, intestinal gas distribution was measured in fast and early postcibal CT scans. The postcibal scan was taken 99 +/- 22 minutes after a 597 +/- 57 kcal meal.
The volume of gas infused per rectum was detected with an accuracy of 100.4 +/- 3.0%. During fasting, intestinal gas volume was 94 +/- 7 mL (excluding two extreme outliers). After the meal, gas content within the gut increased by 64.7% (up to 149 +/- 21 mL, P < 0.01 vs fast) and the increment occurred in the colon (59 +/- 9 mL precibal vs 121 +/- 20 mL postcibal, P < 0.001), while other gut compartments remained unchanged.
Ingestion of a meal activated gas metabolism and increased gas content within the gut. The increment occurred early, presumably prior to colonic fermentation of food substrates and was localized in the distal gut, suggesting that gas had a proximal origin and was propelled caudally.
患者经常抱怨进食引发气体症状，但早期消化对肠道气体含量的影响尚不清楚。我们的目的是确定进餐对肠道气体体积和分布的影响。
首先，我们基于独立软件模块开发了一个CT图像分析程序，以测量肠道内的气体含量。通过对9名健康受试者在直肠注入已知体积的空气（100 - 400 mL）前后进行螺旋腹部CT扫描，对该系统进行了验证。在15名健康受试者中，在禁食和进食后早期的CT扫描中测量肠道气体分布。进食后扫描在摄入597±57千卡的餐后99±22分钟进行。
每直肠注入气体的体积检测准确率为100.4±3.0%。禁食期间，肠道气体体积为94±7 mL（不包括两个极端异常值）。进餐后，肠道内气体含量增加了64.7%（高达149±21 mL），与禁食相比P < 0.01），且增加发生在结肠（进食前59±9 mL，进食后121±20 mL，P < 0.001），而其他肠道区域保持不变。
进食激活了气体代谢并增加了肠道内的气体含量。增加发生得很早，可能在食物底物结肠发酵之前，且局限于远端肠道，这表明气体起源于近端并向尾端推进。
