[Intestinal permeability in Crohn's disease and effects of elemental dietary therapy].
Enteral intake of non-metabolic monosacharide and disaccharide, followed by measurement of the urinary excretion ratio of the two, is a method used to investigate intestinal permeability. L/R ratio (lactulose/1-rhamnose urinary excretion ratio) is considered an indicator of permeability of the small intestine. An increased L/R ratio is caused by mucosal disorders of the small intestine. The L/R ratio in all patients (n = 92) with Crohn's disease was 0.079 +/- 0.081 (mean +/- S.D.), which was significantly higher than the value in normal controls (0.027 +/- 0.009, n = 20, p < 0.05). In 39 patients with Crohn's disease, we assessed intestinal permeability before after treatment with an elemental diet, and during remission. The L/R ratio was 0.120 +/- 0.092, before treatment and 0.065 +/- 0.097 after treatment (p < 0.05), showing increased intestinal permeability before elemental dietary treatment. During remission, the L/R ratio was 0.035 +/- 0.028; this did not differ significantly from the value obtained after treatment. We conclude that intestinal permeability is useful for investigating disease activity in patients with Crohn's disease.
Iwata
M
M
Department of Internal Medicine and Gastroenterology, Fujita Health University.
Nakano
H
H
Matsuura
Y
Y
Nagasaka
M
M
Misawa
M
M
Mizuta
S
S
Ito
I
I
Saito
T
T
Ito
T
T
Hokama
M
M
Kamiya
M
M
Hobara
R
R
Watanabe
M
M
Takahama
K
K
D000293:Adolescent; D000328:Adult; D003424:Crohn Disease / Q000178:diet therapy* / Q000378:metabolism*; D005260:Female; D005526:Food, Formulated; D005765:Gastrointestinal Agents / Q000493:pharmacokinetics; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism*; D007792:Lactulose / Q000493:pharmacokinetics; D008297:Male; D008875:Middle Aged; D010539:Permeability; D012210:Rhamnose / Q000493:pharmacokinetics
D005765:Gastrointestinal Agents; D007792:Lactulose; D012210:Rhamnose