title: Gastrointestinal permeability in celiac disease.
abstract: OBJECTIVE
  Intestinal permeability is increased in patients with active celiac disease. The measurement of sucrose permeability is proposed as a novel means to detect upper gastrointestinal damage, with potentially greater use than conventional methods. The aim of this study was to evaluate the effectiveness of sucrose in the detection of celiac disease.
  
  
  METHODS
  Permeability tests were performed in 27 newly diagnosed patients, at diagnosis, after upper gastrointestinal endoscopies were performed to exclude macroscopic gastric lesions, and after 2 months on a gluten-free diet. Results were compared with those obtained in 30 healthy subjects and 7 patients with chronic diarrhea but no evidence of celiac disease.
  
  
  RESULTS
  At diagnosis, 25 of 27 patients had increased urinary excretion of sucrose. Mean sucrose excretion in patients with untreated celiac disease was significantly increased compared with healthy controls and controls with disease. Sucrose excretion decreased significantly after treatment and completely normalized in 60% of patients. The lactulose-mannitol ratio was abnormal in 26 of 27 patients, with a mean value significantly greater than that observed in healthy controls. This ratio also significantly declined after treatment; however, no values returned to the normal range.
  
  
  CONCLUSIONS
  Increased sucrose permeability is a sensitive marker for advanced celiac disease. Moreover, it decreases rapidly in response to a gluten-free diet and therefore is potentially useful to follow response to therapy.
authors.affiliation: Department of Gastroenterology, Salvador University, Buenos Aires, Argentina.
authors.forename: E
authors.initials: E
authors.lastname: Smecuol
authors.forename: J C
authors.initials: JC
authors.lastname: Bai
authors.forename: H
authors.initials: H
authors.lastname: Vazquez
authors.forename: Z
authors.initials: Z
authors.lastname: Kogan
authors.forename: A
authors.initials: A
authors.lastname: Cabanne
authors.forename: S
authors.initials: S
authors.lastname: Niveloni
authors.forename: S
authors.initials: S
authors.lastname: Pedreira
authors.forename: L
authors.initials: L
authors.lastname: Boerr
authors.forename: E
authors.initials: E
authors.lastname: Mauriño
authors.forename: J B
authors.initials: JB
authors.lastname: Meddings
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002446:Celiac Disease / Q000178:diet therapy / Q000378:metabolism*; D004032:Diet; D004064:Digestive System / Q000378:metabolism*; D005260:Female; D005983:Glutens / Q000008:administration & dosage; D006801:Humans; D007792:Lactulose / Q000493:pharmacokinetics; D008297:Male; D008353:Mannitol / Q000493:pharmacokinetics; D008875:Middle Aged; D010539:Permeability; D011446:Prospective Studies; D013395:Sucrose / Q000493:pharmacokinetics
chemical_list: D008353:Mannitol; D007792:Lactulose; D013395:Sucrose; D005983:Glutens