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Related Experiment Videos

Intestinal permeability in kwashiorkor

D R Brewster1, M J Manary, I S Menzies

  • 1College of Medicine, University of Malawi, Blantyre, Malawi.

Archives of Disease in Childhood
|March 1, 1997
PubMed
Summary

Abnormal intestinal permeability is common in kwashiorkor and linked to severe illness. The lactulose-rhamnose (L-R) test showed slow improvement in gut integrity despite nutritional rehabilitation.

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Area of Science:

  • Pediatric Nutrition
  • Gastroenterology
  • Clinical Medicine

Background:

  • Intestinal permeability, a key indicator of small intestinal integrity, can be assessed non-invasively using the lactulose-rhamnose (L-R) test.
  • Kwashiorkor, a severe form of malnutrition, is suspected to involve compromised gut barrier function.

Purpose of the Study:

  • To identify risk factors associated with abnormal intestinal permeability in children with kwashiorkor.
  • To evaluate the changes in L-R ratios during inpatient nutritional rehabilitation for kwashiorkor.

Main Methods:

  • A case-control study involving 149 children with kwashiorkor and 45 hospital controls in Malawi.
  • The lactulose-rhamnose (L-R) test was administered weekly during nutritional rehabilitation.
  • Urine sugar levels were quantified using thin-layer chromatography.

Main Results:

  • Kwashiorkor cases exhibited significantly higher L-R ratios (17.3) compared to controls (7.0), indicating impaired intestinal permeability.
  • Abnormal permeability in kwashiorkor was associated with increased mortality, oliguria, sepsis, diarrhea, wasting, and younger age.
  • Despite clinical recovery, L-R ratios showed minimal improvement over the treatment period.

Conclusions:

  • Abnormal intestinal permeability is a significant correlate of disease severity in kwashiorkor.
  • Gut barrier function, as measured by L-R ratios, improves very slowly even with effective nutritional rehabilitation.

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