[Measurement of selective intestinal permeability using a new, simple sugar absorption test].
OBJECTIVE
To study the clinical value of the sugar absorption test (SAT) as a function test of the selective permeability of the small intestine in various intestinal diseases.


METHODS
Inventory of the results of the SAT in a number of patient groups and controls.


METHODS
Beatrix Children's Hospital, Groningen and Rijnstate Hospital, Arnhem.


METHODS
The SAT was performed in 51 controls (25 children, 26 adults) and in a number of diseases: (suspected) allergy to cow's milk albumin (30 children), (suspected) coeliac disease (86 children and 35 adults), Crohn's disease (25 patients) with ulcerative colitis (9), and pancreatic insufficiency (31) due to cystic fibrosis or chronic pancreatitis. For the SAT, the fasting patient is given a solution of mannitol (M) and lactulose (L) following which the L/M ratio, as an indicator of the selective intestinal permeability, is determined in 5-hour urine by means of gas chromatography.


RESULTS
In cow's milk protein allergy, the L/M ratio showed a statistically significant increase in clinically positive cow's milk provocation results, unlike that in clinically negative results. After pretreatment with cromoglycate this difference decreased to non-significant values. The L/M ratio was increased in active coeliac disease (with villous atrophy), first-degree relatives of coeliac disease patients, Crohn's disease, clinically active ulcerative colitis and pancreatic insufficiency. The L/M ratio was not increased in inactive coeliac disease (with normal villi), suspicion of coeliac disease because of short stature, dystrophy and/or aspecific gastrointestinal symptoms with normal villi, and in clinically inactive ulcerative colitis.


CONCLUSIONS
The selective intestinal permeability can be determined by means of the SAT. This could be an important tool for diagnosis and evaluation of therapy in gastrointestinal disorders.
van Elburg
R M
RM
Beatrix Kinderkliniek, Academisch Ziekenhuis, Groningen.
Kokke
F T
FT
Uil
J J
JJ
Mulder
C J
CJ
de Monchy
J G
JG
Heymans
H S
HS
D000328:Adult; D050260:Carbohydrate Metabolism; D002241:Carbohydrates; D002446:Celiac Disease / Q000378:metabolism; D002463:Cell Membrane Permeability; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000378:metabolism; D003424:Crohn Disease / Q000378:metabolism; D010188:Exocrine Pancreatic Insufficiency / Q000378:metabolism; D006801:Humans; D007223:Infant; D007408:Intestinal Absorption; D007413:Intestinal Mucosa / Q000378:metabolism*; D007787:Lactose Intolerance / Q000378:metabolism
D002241:Carbohydrates