Digestive Diseases and Sciences

, Volume 43, Issue 9, pp 1946–1950

Assessment of Intestinal Permeability with a Two-Hour Urine Collection

  • Sharmeen Akram
  • Samir Mourani
  • Ching-Nan Ou
  • Cheryl Rognerud
  • Raheela Sadiq
  • Richard W. Goodgame
Article

Abstract

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.

INTESTINAL PERMEABILITY LACTULOSE MANNITOL SMALL INTESTINE MUCOSAL PERMEABILITY 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

REFERENCES

  1. 1.
    Juby L, Rothwell J, Axon A: Lactulose/mannitol test: an ideal screening test for celiac disease. Gastroenterology 96: 79–85, 1989PubMedGoogle Scholar
  2. 2.
    Wyatt J, Vogelsang H, Hubl W, Waldhoer T, Lochs H: Intestinal permeability and the prediction of relapse in Crohn's disease. Lancet 341: 1437–1439, 1993CrossRefPubMedGoogle Scholar
  3. 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
  4. 4.
    Teahon K, Smethurst P, Levi A, Bjarnason I: The effect of elemental diet on intestinal permeability and inflammation in Crohn's disease. Gastroenterology 101: 84–89, 1991PubMedGoogle Scholar
  5. 5.
    Goodgame R, Kimball K, Ou C-N, White AC, Genta RM, Lifschitz CH, Chappell CL: Intestinal function and injury in AIDS-related cryptosporidiosis. Gastroenterology 108: 1075–1082, 1995PubMedGoogle Scholar
  6. 6.
    Bjarnason I, MacPherson A, Hollander D: Intestinal permeability: An ove rview. Gastroenterology 108: 1566–1581, 1995PubMedGoogle Scholar
  7. 7.
    Catassi C, Pierani P, Natalini G, Gabrielli O, Coppa G, Giorgi P: Clinical application of a simple HPLC method for the sugar intestinal perme ability test. J Pediatr Gastroenterol Nutr 12: 209–212, 1991PubMedGoogle Scholar
  8. 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
  9. 9.
    Maxton D, Bjarnason I, Reynolds A, Catt S, Peters T, Menzies I: Lactulose, 51Cr-labeled ethylenediamine tetra-acetate, Lrhamnose and polyethyene-glycol 500 as probe markers for assessment in vivoof human intestinal perme ability. Clin Sci 71: 71–80, 1986PubMedGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1998

Authors and Affiliations

  • Sharmeen Akram
  • Samir Mourani
  • Ching-Nan Ou
  • Cheryl Rognerud
  • Raheela Sadiq
  • Richard W. Goodgame

There are no affiliations available

Personalised recommendations