Original Article

Digestive Diseases and Sciences

, Volume 55, Issue 3, pp 716-723

Intestinal Permeability in Irritable Bowel Syndrome Patients: Effects of NSAIDs

  • Angèle P. M. KerckhoffsAffiliated withGastrointestinal Research Unit of Departments of Gastroenterology, University Medical Center Utrecht Email author 
  • , Louis M. A. AkkermansAffiliated withGastrointestinal Research Unit of Departments of Surgery, University Medical Center Utrecht
  • , Martin B. M. de SmetAffiliated withGastrointestinal Research Unit of Departments of Surgery, University Medical Center Utrecht
  • , Marc G. H. BesselinkAffiliated withGastrointestinal Research Unit of Departments of Surgery, University Medical Center Utrecht
  • , Falco HietbrinkAffiliated withGastrointestinal Research Unit of Departments of Surgery, University Medical Center Utrecht
  • , Imke H. BartelinkAffiliated withDepartment of Pharmacy, University Medical Center Utrecht
  • , Wim B. BusschersAffiliated withCenter for Biostatistics, Utrecht University
  • , Melvin SamsomAffiliated withGastrointestinal Research Unit of Departments of Gastroenterology, University Medical Center Utrecht
  • , Willem RenooijAffiliated withGastrointestinal Research Unit of Departments of Surgery, University Medical Center Utrecht

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Abstract

Intestinal permeability and the effect of NSAIDs on permeability were investigated in 14 irritable bowel syndrome (IBS) patients and 15 healthy subjects. In the study, 24-h urinary recoveries of orally administered polyethylene glycols (PEGs 400, 1500, and 4000) were not significantly different in healthy subjects and IBS patients before or after NSAID ingestion. Lactulose mannitol ratios in healthy subjects and IBS patients were not significantly different. Only time-dependent monitoring of PEG excretion showed that NSAIDs enhanced intestinal permeability for PEG 4000 in healthy subjects (P = 0.050) and for PEGs 400, 1500, and 4000 in IBS patients (P = 0.012, P = 0.041, and P = 0.012, respectively). These results show that intestinal permeability in IBS patients is not different from that in healthy subjects; NSAIDs compromise intestinal permeability in IBS patients to a greater extent than in healthy subjects, which suggests that IBS is associated with an altered response of the intestinal barrier to noxious agents.

Keywords

NSAIDs Polyethylene glycol PEG Intestinal permeability IBS