Related Experiment Videos
Intestinal sugar permeability: relationship to diarrhoeal disease and small bowel morphology
Insights
Intestinal permeability, measured by sugar absorption tests, is significantly increased in children with acute gastroenteritis and chronic diarrhea. This increased permeability normalizes after recovery, indicating it
Area of Science:
- Pediatric Gastroenterology
- Intestinal Physiology
- Diagnostic Biomarkers
Background:
- Intestinal permeability is crucial for nutrient absorption and barrier function.
- Altered intestinal permeability is implicated in various pediatric gastrointestinal disorders.
- Assessing intestinal permeability aids in understanding mucosal integrity.
Purpose of the Study:
- To investigate intestinal permeability in children with diarrhea.
- To correlate intestinal permeability with duodenal morphology.
- To evaluate intestinal permeability as an index of mucosal integrity.
Main Methods:
- Differential absorption of orally administered sugars (lactulose, L-rhamnose, D-xylose, lactose) was measured.
- Urinary sugar excretion was quantified using thin-layer chromatography.
- Intestinal permeability was assessed via the lactulose/L-rhamnose excretion ratio.
Main Results:
- Children with acute gastroenteritis exhibited significantly increased intestinal permeability (lactulose/L-rhamnose ratio = 0.43 ± 0.31).
- Permeability normalized after recovery from gastroenteritis (0.045 ± 0.018).
- Children with chronic diarrhea showed elevated permeability (0.12 ± 0.074), less than acute cases.
- Abnormal proximal small bowel morphology correlated with increased permeability (r = 0.66).
Conclusions:
- Abnormal intestinal permeability is associated with diarrheal diseases in children.
- Increased permeability correlates with mucosal damage and abnormal small bowel morphology.
- Intestinal permeability serves as a reliable index of mucosal integrity in pediatric patients.
Abstract:
The permeability of the intestine was studied in 39 children (1 month to 3 years of age) with diarrhoea and in 28 children (6 months to 15 years of age) undergoing duodenal biopsy. Permeability was measured by differential absorption from an isotonic oral load containing 3.5 g lactulose, 0.5 g L-rhamnose, 0.5 g D-xylose, and 5 g lactose. Urinary sugar excretion was determined by quantitative thin-layer chromatography. Children with acute gastroenteritis had a greatly increased permeability, with a mean lactulose/L-rhamnose excretion ratio of 0.43 +/- 0.31 (normal less than 0.07). Children retested 3-16 weeks after complete recovery of their gastroenteritis had normal permeability (0.045 +/- 0.018). Children with chronic diarrhoea also had an increased permeability (0.12 +/- 0.074), but significantly less than the acute gastroenteritis group (p less than 0.01). Abnormal proximal small bowel morphology was associated with increased permeability, and a strong correlation between crypt depth and permeability was observed (r = 0.66, p less than 0.001). Abnormal intestinal permeability was associated with diarrhoeal disease and with mucosal damage. It appears to be a reliable and useful index of mucosal integrity.