Abstract
Purpose : Fungal-type dysbiosis (FTD) is still an unproven diagnosis. Patients are polysymptomatic, but most have symptoms of irritable bowel. Treatment, using a diet low in fermentable, yeasty and mould-containing foods with or without antifungal drugs, is often rewarding. Patients with FTD show elevated blood ethanol levels after fasting glucose challenge. Because of this most authors suggest a fungal cause. Hydrogen generation is a bacterial fermentation product and would only be expected if a bacterial cause was present. It was therefore decided to correlate ethanol and hydrogen production. Design : Statistical comparison of ethanol producers and non-producers with respect to breath hydrogen and symptomatology. Materials and Methods : The gut fermentation profile was performed by gas-liquid chromatography, and measured ethanol, a number of higher alcohols and short-chain fatty acids. Lactulose breath hydrogen estimations were by gas chromatography. Statistics were calculated using Pearson's rank correlation and the chi-squared test, using Microsoft Excel packages. Results : Two groups were studied. The first produced excess ethanol ( n = 18) and the second ( n = 20) did not. Both groups included patients producing hydrogen. There was no statistical correlation between levels of ethanol and hydrogen production. Conclusions : If FTD is solely due to yeasts, our ethanol positive group should not produce hydrogen, solely a bacterial ferment, but the ethanol negative group should. If the conventional view, that yeasts do not produce hydrogen as a fermentation product, is correct, it appears from the commonness of breath hydrogen positives in this series that bacterial fermentation is in some way implicated in FTD.