title: Gastric permeability to sucrose is increased in portal hypertensive gastropathy.
abstract: BACKGROUND
  Portal hypertensive gastropathy (PHG) is frequently found among patients with hepatic cirrhosis and at present the only way to detect and follow PHG is via endoscopy.
  
  
  OBJECTIVE
  To assess gastric and intestinal permeability and investigate its relationship to endoscopic findings and indices of portal hypertension and hepatic function.
  
  
  METHODS
  Thirty-one non-diabetic patients with hepatic cirrhosis and PHG (PHG+) were studied and compared with 17 cirrhotic patients without PHG (PHG-). All patients underwent endoscopy for the assessment of PHG and Helicobacter pylori status, ultrasound determination of the diameters of spleen and portal vein, and, subsequently, an oral load of sucrose, lactulose, and mannitol. Sugar concentrations were determined in 6-h urine specimens and expressed as a percentage of the orally administered dose or as lactulose/mannitol ratio.
  
  
  RESULTS
  The urinary sucrose excretion was significantly elevated in patients with PHG compared to those without (PHG+, 0.20% +/- 0.03; PHG-, 0.07% +/- 0.01; P< 0.001). No difference was found for the small intestinal probes lactulose and mannitol. Gastric sucrose permeability correlated positively with the endoscopic lesion score (P < 0.001), but not with other parameters of portal hypertension or hepatic function. H. pylori status did not influence gastric permeability. The sensitivity of this test reached 100% for PHG scores > 2.
  
  
  CONCLUSIONS
  Gastric permeability to sucrose is increased in patients with PHG, independently of the presence of H. pylori. Sucrose permeability may be useful for the follow-up of patients with PHG.
authors.affiliation: Gastroenterologia, Università di Messina, Italy.
authors.forename: M R
authors.initials: MR
authors.lastname: Giofré
authors.forename: G
authors.initials: G
authors.lastname: Meduri
authors.forename: S
authors.initials: S
authors.lastname: Pallio
authors.forename: S
authors.initials: S
authors.lastname: Calandra
authors.forename: A
authors.initials: A
authors.lastname: Magnano
authors.forename: D
authors.initials: D
authors.lastname: Niceforo
authors.forename: M
authors.initials: M
authors.lastname: Cinquegrani
authors.forename: V
authors.initials: V
authors.lastname: di Leo
authors.forename: E
authors.initials: E
authors.lastname: Mazzon
authors.forename: G C
authors.initials: GC
authors.lastname: Sturniolo
authors.forename: G
authors.initials: G
authors.lastname: Longo
authors.forename: W
authors.initials: W
authors.lastname: Fries
mesh_terms: D005260:Female; D005753:Gastric Mucosa / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications*; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010539:Permeability; D011237:Predictive Value of Tests; D018709:Statistics, Nonparametric; D013272:Stomach Diseases / Q000209:etiology* / Q000473:pathology; D013395:Sucrose / Q000008:administration & dosage / Q000652:urine*
chemical_list: D013395:Sucrose