ALTERATIONS IN INTESTINAL BARRIER FUNCTION DO NOT PREDISPOSE TO TRANSLOCATION OF ENTERIC BACTERIA IN GASTROENTEROLOGIC PATIENTS

Bacterial translocation from the intestinal lumen has been demonstrate d in humans. Three mechanisms have been suggested to explain the pheno menon: altered intestinal barrier function, bacterial overgrowth, and impaired host defense. The aim of this study was to determine whether changes in intestinal barrier function assessed by measurement of inte stinal permeability and morphology were associated with alteration in bacterial translocation. Intestinal permeability was assessed in 43 pa tients by the lactulose/L-rhamnose test with a 5-h urine collection. M ucosal atrophy was assessed from the villus height-to-mucosal thicknes s ratio in small-bowel biopsies. Bacterial translocation was determine d by microbiologic analysis of harvested mesenteric lymph nodes. No si gnificant differences were apparent in the incidence of bacterial tran slocation in patients with normal permeability (5 [23%] of 22 patients translocated) compared with patients with increased permeability (4 [ 19%] of 21 patients translocated). Similarly, no correlation was appar ent between the incidence of bacterial translocation and the index of villus atrophy. The degree of villus atrophy failed to correlate with gastrointestinal permeability. These data suggest that the incidence o f bacterial translocation is not related to increased intestinal perme ability or mucosal atrophy. (C) Elsevier Science Inc. 1998.