Levitt, Michael D., M.D.

GASTROENTEROLOGY/ INTERNAL MEDICINE

During the past year I have carried out research studies on several gastroenterological problems: • Ulcerative Colitis - Colonic bacteria liberate large quantities of highly toxic gases, hydrogen sulfide and methanethiol, and it is postulated that they could play an etiologic role in ulcerative colitis. We are investigating the mechanism utilized by colonic mucosa to detoxify these gases and have found that methanethiol is demethylated to hydrogen sulfide and hydrogen sulfide is converted to thiosulfate. We are currently studying the detoxification of these gases by normal colonic mucosa and mucosa obtained from patients with ulcerative colitis to see if this mechanism is altered in diseased tissue. • Lactose Intolerance – We completed a study that found lactose maldigestors were capable of drinking two cups of milk daily without appreciable symptoms when their milk was taken with a meal, breakfast and supper. We then studied the ability of lactose maldigestors to tolerate the intake of 1500mg of calcium per day as dairy products. We found a significant increase in flatus frequency and subjective impression of rectal gas release, however, bloating, abdominal pain, diarrhea, and the global perception of overall symptom severity was not significantly different between treatment with lactose-free dairy products and those containing lactose. The symptoms resulting from lactose maldigestion are not a major impediment to the ingestion of a dairy-rich diet. • Halitosis – We are using breath sulfur levels to assess whether the mouth or the gut is responsible for odoriferous breath gases and to test purported halitosis treatments for their effectiveness. • Intestinal Gas – We studied the effectiveness of ingested charcoal on reducing the release of gases produced by colonic flora and found no significant reduction in the release of any fecal gases. We also tested a pancreatic supplement for its effect on intestinal gas production and related symptoms. The pancreatic supplement reduced postprandial symptoms experienced by healthy volunteers after ingestion of a high calorie, high fat meal. We are currently studying the effect of diet on gas production.