Intestinal permeability in cirrhotic patients with and without ascites.
OBJECTIVE
It has been suggested that increased intestinal permeability plays a pathogenic role in bacterial infections, such as spontaneous bacterial peritonitis, in patients with liver cirrhosis. The aim of this study was to assess whether intestinal permeability is altered in cirrhotic patients with and without ascites.


METHODS
Intestinal permeability was assessed by a (51)Cr-EDTA permeability test in 20 cirrhotic patients (10 with and 10 without ascites) along with 20 age- and gender-matched healthy controls. In six patients with ascites, the test was performed before and after therapeutic paracentesis.


RESULTS
The median (IQR) 24-h urinary excretion of (51)Cr-EDTA was higher in patients with cirrhosis (1.94% (1.21-2.70%)) compared with that in controls (1.40% (1.09-1.99%); p<0.05). Patients with (2.05% (1.50-3.46%); p<0.05) but not those without ascites (1.94% (1.13-2.53%); p>0.1) had significantly higher excretion values compared with those of controls. Only one patient without ascites and a total of four patients with ascites had increased intestinal permeability ((51)Cr-EDTA excretion > 95% confidence than that of controls; p>0.1). Paracentesis did not affect urinary (51)Cr-EDTA excretion significantly (1.69% (1.16-2.86%) versus 1.30% (1.08-1.79%) before and after, respectively; p>0.1). No significant correlation was found between clinical severity scores for liver disease and intestinal permeability.


CONCLUSIONS
Only a small proportion of patients with liver cirrhosis have increased intestinal permeability and it is unlikely that this plays any major role in predisposing these patients to infections.
Department of Internal Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden. evangelos.kalaitzakis@vgregion.se
Evangelos
E
Kalaitzakis
Jan-Erik
JE
Johansson
Ingvar
I
Bjarnason
Einar
E
Björnsson
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000150:complications / Q000378:metabolism*; D002614:Chelating Agents / Q000493:pharmacokinetics; D018450:Disease Progression; D004492:Edetic Acid / Q000493:pharmacokinetics; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism*; D008103:Liver Cirrhosis / Q000150:complications / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010539:Permeability; D011379:Prognosis; D012720:Severity of Illness Index
D002614:Chelating Agents; D004492:Edetic Acid