Increased breath nitrous oxide after ingesting nitrate in patients with atrophic gastritis and partial gastrectomy

Background: Toxic nitrite and N-nitroso compounds due to gastric bacterial growth are often detected in the stomach of patients with atrophic gastritis and partial gastrectomy. The aim of this study is to investigate whether breath N2O, a major metabolite of denitrification, detected after ingestion of nitrate is associated with atrophic gastritis and partial gastrectomy. Methods: Nine young. 16 normal older, nine atrophic gastritis and six partial gastrectomy subjects ingested 100 g lettuce, equal to 130 mg nitrate, and breath N2O was measured at 15-min intervals for 5 h. N2O was analyzed using an infrared-photoacoustic analyzer, and atrophic gastritis was diagnosed by pepsinogen test. Results: The mean breath N2O concentrations were higher in the following order at all times: partial gastrectomy>atrophic gastritis>normal>young. The maximum N2O concentrations in the patients with partial gastrectomy and atrophic gastritis were 1655 +/- 296 and 1350 +/- 200 (mean +/- S.E.) ppb, respectively, which were higher than that of the normal subjects, 827 +/- 91 ppb (P < 0.05). The maximum N2O concentration in young people was 527 +/- 86 ppb, which was lower than that of the normal older people (P < 0.051). Conclusion: These higher N2O concentrations in gastric patients reflect bacterial growth in the stomach due to the reduction of gastric acid. (C) 2004 Elsevier B.V. All rights reserved.