Assessment of Intestinal Permeability in (Premature) Neonates by Sugar Absorption Tests

  • Willemijn E. Corpeleijn
  • Ruurd M. van Elburg
  • Ido P. Kema
  • Johannes B. van Goudoever
Part of the Methods in Molecular Biology book series (MIMB, volume 763)


Infants born prematurely have an enhanced intestinal permeability compared to healthy term infants. This enhanced permeability might be a contributing factor in the development of Necrotising Enterocolitis. The assessment of intestinal permeability in premature neonates with sugar absorption tests has been proven to be safe and of minimal burden to the infant. After enteral administration of a test solution containing lactulose and mannitol, the excretion of these sugars is measured in urine, and the ratio is calculated. The lactulose and mannitol concentrations in urine can be measured by the use of a gas chromatograph after pre-purification and derivatisation of the sample. Non-invasive assessment of intestinal permeability can be useful in monitoring the effects of experimental (nutritional) therapy.

Key words

Intestinal permeability Premature neonate Lactulose Mannitol Sugar absorption test Gas chromatography 


  1. 1.
    van Elburg R M, Uil J J, Mulder C J et al. (1993) Intestinal permeability in patients with coeliac disease and relatives of patients with coeliac disease. Gut. 34(3): p. 354–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Pearson A D, Eastham E J, Laker M F et al. (1982) Intestinal permeability in children with Crohn’s disease and coeliac disease. Br Med J (Clin Res Ed). 285(6334): p. 20–1.CrossRefGoogle Scholar
  3. 3.
    van Elburg R M, Fetter W P F, Bunkers C M, et al. (2003) Intestinal permeability in relation to birth weight and gestational and postnatal age. Arch Dis Child Fetal Neonatal Ed 88(1): p. F52–5.PubMedCrossRefGoogle Scholar
  4. 4.
    Kelly D, Coutts A G (2000) Early nutrition and the development of immune function in the neonate. Proc Nutr Soc. 59(2): p. 177–85.PubMedCrossRefGoogle Scholar
  5. 5.
    Teitelbaum J E, Walker W A (2005) The development of mucosal immunity. Eur J Gastroenterol Hepatol. 17(12): p. 1273–8.PubMedCrossRefGoogle Scholar
  6. 6.
    Taylor S N, Basile L A, Ebeling M, et al. (2009) Intestinal permeability in preterm infants by feeding type: Mother’s milk versus formula. Breastfeed Med.; Mar (4)1:11–5Google Scholar
  7. 7.
    van den Berg A, Fetter W P F, Westerbeek E A M et al. (2006) The effect of glutamine-enriched enteral nutrition on intestinal permeability in very-low-birth-weight infants: a randomized controlled trial. JPEN J Parenter Enteral Nutr. 30(5): p. 408–14.PubMedCrossRefGoogle Scholar
  8. 8.
    Corpeleijn W E, van Vliet I, de Gast-Bakker D A et al. (2008) Effect of enteral IGF-1 supplementation on feeding tolerance, growth, and gut permeability in enterally fed premature neonates. J Pediatr Gastroenterol Nutr. 46(2): p. 184–90.PubMedCrossRefGoogle Scholar
  9. 9.
    Uil, J J, van Elburg R M, Janssens P M W et al. (2000) Sensitivity of a hyperosmolar or “low”-osmolar test solution for sugar absorption in recognizing small intestinal mucosal damage in coeliac disease. Dig Liver Dis. 32(3): p. 195–200.PubMedCrossRefGoogle Scholar
  10. 10.
    Jansen G, Muskiet F A J, Schierbeek H, et al. (1986) Capillary gas chromatographic profiling of urinary, plasma and erythrocyte sugars and polyols as their trimethylsilyl derivatives, preceded by a simple and rapid prepurification method. Clin Chim Acta. 157(3): p. 277–93.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Willemijn E. Corpeleijn
    • 1
  • Ruurd M. van Elburg
    • 2
  • Ido P. Kema
    • 3
  • Johannes B. van Goudoever
    • 1
  1. 1.Division of NeonatologyErasmus MC – Sophia Children’s HospitalRotterdamThe Netherlands
  2. 2.Department of Pediatrics, Division of NeonatologyVrije Universiteit Medical CenterAmsterdamThe Netherlands
  3. 3.Department of Laboratory Medicine, Division of Clinical Chemistry and HematologyUniversity Medical Center GroningenGroningenThe Netherlands

Personalised recommendations