Abstract
Purpose: Patients with gut dysbioses are clinically difficult to distinguish from those with food intolerance. The variety known as fungal-type is associated with the generation of small amounts of ethanol in the blood. A recent study has shown abnormalities of histidine metabolism. In view of this, gastric function was studied. This also provided data on pancreatic function. Design: Two groups of newly referred patients, with similar symptom profiles, attending two clinicians were studied. Group A (42 patients) had positive ethanol fermentation tests: group B (37 patients) did not. There were 20 healthy control subjects. Levels of higher alcohols, short-chain fatty acids, gastric acid production and pancreatic exocrine secretions were measured and compared statistically. Materials and Methods: Ethanol, higher alcohols and short-chain fatty acids were measured by gas-liquid chromatography. Gastric acid production, emptying time and pancreatic function were measured using a swallowed transducer. Results: A significant number of group A patients had elevated levels of higher alcohols; all of these also showed excess short-chain fatty acids. Group B patients showed similar findings for both; these figures were not statistically significant. However, as compared with group B, group A patients were less likely to show lower levels of gastric acid and/or pancreatic enzyme production and these results were statistically highly significant. Conclusions: As these findings show minimal effects on stomach and duodenum, it is suggested that fungal-type dysbiosis is largely an ileal condition. For these patients, the presence of elevated levels of higher alcohols with a positive ethanol test is a better indicator of disease severity.