ASSESSING THE SITE OF INCREASED INTESTINAL PERMEABILITY IN CELIAC ANDINFLAMMATORY BOWEL-DISEASE

Background-The precise site of intestinal permeability changes in pati ents with coeliac and inflammatory bowel disease is unknown. Aims-To d esign a non-invasive technique for the localisation of altered gastroi ntestinal permeability to (51)chromium labelled EDTA ((51)CrEDTA). The method depends on comparing and defining concentration/time profiles in serum of a series of simultaneously ingested indicators with a well defined absorption site (3-0-methyl-D-glucose (jejunal indicator), (5 7)cobalt labelled vitamin B-12 (heal indicator), and sulphasalazine (c aecal-colonic indicator)) in relation to simultaneously ingested (51)C rEDTA. Subjects-Five normal controls, six patients with untreated coel iac disease, five with Crohn's ileitis, and five with pan-ulcerative c olitis underwent study, which entailed the simultaneous ingestion of t he above four test substances followed, during the next 24 hours, by t imed serial collection of urine and serum for marker analysis. Results -Urinary excretion of (51)CrEDTA was significantly increased in all pa tient groups. Analysis of serum appearances and profiles of the marker s suggested that the increased intestinal permeation of (51)CrEDTA too k place in the diseased jejunum in patients with coeliac disease, pred ominantly in the ileum in Crohn's disease and in the colon in the pati ents with pan-ulcerative colitis.Conclusion-A new non-invasive techniq ue has been assessed that permits the localisation of the site of perm eability changes with the gastrointestinal tract.