title: Gastroduodenal permeability in Crohn's disease.
abstract: BACKGROUND
  Gastric permeability was prospectively investigated by determination of sucrose excretion in 100 patients with Crohn's disease. Results were compared with histological findings and the lactulose-mannitol ratio as a measure of intestinal permeability.
  
  
  METHODS
  All subjects underwent oesophagogastroduodenoscopy with biopsies of all investigated parts. Thirty-two Helicobacter pylori-positive patients were excluded from further analyses.
  
  
  RESULTS
  Gastroduodenal permeability was significantly higher in patients with Crohn's disease than in control subjects (P < 0.00001). Sucrose excretion alone did not predict microscopic inflammation of the upper gastrointestinal tract. Increased gastroduodenal permeability with a concomitant rise in intestinal permeability predicted histological upper gastrointestinal involvement of Crohn's disease with a likelihood of 86%. The negative predictive value was 43%.
  
  
  CONCLUSIONS
  In parallel with findings in the small intestine, gastroduodenal permeability is increased in a high proportion of patients with Crohn's disease. In patients with an increased lactulose-mannitol ratio, elevated sucrose excretion is highly predictive of histological gastroduodenal involvement.
authors.affiliation: Department of Gastroenterology and Hepatology, University of Vienna, Austria. andreas.puespoek@akh-wien.ac.at
authors.forename: A
authors.initials: A
authors.lastname: Püspök
authors.forename: G
authors.initials: G
authors.lastname: Oberhuber
authors.forename: J
authors.initials: J
authors.lastname: Wyatt
authors.forename: T
authors.initials: T
authors.lastname: Maier-Dobersberger
authors.forename: J
authors.initials: J
authors.lastname: Hammer
authors.forename: F
authors.initials: F
authors.lastname: Pfeffel
authors.forename: F
authors.initials: F
authors.lastname: Wrba
authors.forename: R
authors.initials: R
authors.lastname: Pötzi
authors.forename: H
authors.initials: H
authors.lastname: Vogelsang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002463:Cell Membrane Permeability; D003424:Crohn Disease / Q000378:metabolism* / Q000473:pathology; D004386:Duodenum; D005260:Female; D005753:Gastric Mucosa / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013395:Sucrose / Q000493:pharmacokinetics
chemical_list: D013395:Sucrose