Assessment of Intestinal Permeability with a Two-Hour Urine Collection
- 58 Downloads
The differential urinary excretion of orally administered lactulose and mannitol is used to evaluate intestinal permeability. This test usually involves a 5- to 6-hr urine collection. We hypothesized that a shorter collection time would give an equivalent result. Forty-three patients with a variety of gastrointestinal symptoms and diagnoses (group 1) and 42 patients with Crohn's disease (group 2) had a standard lactulose/mannitol permeability test. The lactulose and mannitol urinary excretion was calculated using the first urine (group 1) or the 1-hr and 2-hr urine (group 2) and was compared to the values calculated from the routine 5- or 6-hr collection. Lactulose excretion kinetics, expressed as the percent of the total urinary excretion within a given time period, were as follows: 21% in first hour (group 2), 29% in second hour (group 2), and 46% in first 2.5 hr (group 1). Mannitol urinary excretion kinetics were 16%, 31%, and 44%, respectively. The lactulose/mannitol ratio based on a standard urine collection correlated well with the ratio based on just the first urine produced by the patient (R2 = 0.94; P < 0.001; group 1) and the 2-hr urine (R2 = 0.464; P < 0.001; group 2). Future use of the lactulose/mannitol ratio to assess intestinal permeability may be able to be simplified by shortening the urine collection time.
Unable to display preview. Download preview PDF.
- 3.Keating J, Bjarnason I, Somasundaram S, MacPherson A, Francis N, Price AB, Sharpstone D, Smithson J, Menzies IS, Gazzard B: Intestinal absorptive capacity, intestinal permeability, and jejunal histology in HIV infected patients and their relation to diarrhea. Gut 36: 623–629, 1995Google Scholar
- 8.Bjarnason I, Maxton D, Reynolds A, Catt S, Peters T, Menzies I: Comparison of four markers of intestinal permeability in control subjects and patients with celiac disease. Scand J Gastroenterol 26: 630–639, 1994Google Scholar