Effect of diosmectite on intestinal permeability changes in acute diarrhea: a double-blind placebo-controlled trial.
The effect of diosmectite on intestinal permeability changes in acute diarrhea was measured during a double-blind placebo-controlled trial carried out in 59 Gabonese children aged 5-35 months. Intestinal permeability tests (IPTs), measuring the urinary elimination of orally administered lactulose and mannitol at a dosage of 1 g/10 kg each, were performed during the morning following admission and repeated 2 days later after treatment by diosmectite or placebo. During the first IPT, urine volume and lactulose and mannitol urinary recoveries were comparable in the diosmectite and in the placebo groups: 50 vs. 35.5 ml (median; p = 0.21), 1.01 vs. 1.27% (p = 0.35), and 2.20 vs. 2.87% (p = 0.12). As a result, the lactulose/mannitol (L/M) ratio was similar in the two groups: 44.44 vs. 35.33% (p = 0.98). During the second IPT, the urinary lactulose recovery decreased similarly in both groups (-0.18 vs. -0.29%; p = 0.76), whereas the urinary mannitol recovery exhibited opposite variations, the increase in the diosmectite group (+ 1.43%) contrasting significantly with the decrease in the placebo group (-0.47%; p = 0.01). When comparing the first and the second IPT, the decrease of the L/M ratio was significant in the diosmectite group (44.44 vs. 28.32%; p = 0.02) and not in the placebo group (35.33 vs. 48.23%; p = 0.91). During gastroenteritis, diosmectite appears to enhance absorption of mannitol, a marker of intestinal absorptive area.
Dupont
C
C
Département de Pédiatrie, Hôpital Saint Vincent de Paul, Paris, France.
Moreno
J L
JL
Barau
E
E
Bargaoui
K
K
Thiane
E
E
Plique
O
O
D000208:Acute Disease; D000284:Administration, Oral; D002675:Child, Preschool; D003967:Diarrhea / Q000188:drug therapy* / Q000378:metabolism; D004311:Double-Blind Method; D005765:Gastrointestinal Agents / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007408:Intestinal Absorption / Q000187:drug effects*; D007413:Intestinal Mucosa / Q000187:drug effects; D007785:Lactose / Q000493:pharmacokinetics; D008353:Mannitol / Q000493:pharmacokinetics; D017640:Silicates
D005765:Gastrointestinal Agents; D017640:Silicates; D008353:Mannitol; C033214:Smectite; D007785:Lactose