Intestinal permeability in liver cirrhosis

Objective To determine the changes in intestinal permeability in liver cirr hosis and to investigate whether intestinal permeability relates to the sta ge and aetiology of cirrhosis or existence of spontaneous bacterial periton itis (SBP). Design A prospective study of intestinal permeability in patients with cirr hosis. Setting Gastroenterology and Nuclear Medicine Departments of Ege University Hospital. Participants Intestinal permeability was assessed in 44 consecutive patient s with cirrhosis and 10 healthy volunteers by measuring 24 h urine excretio n of (99m)technetium diethyl triamine penta-acetic acid (Tc-99m DTPA). Case s with an associated disease, impaired renal function, continuing alcohol c onsumption and drug intake which is known to have an effect on intestinal p ermeability were excluded. Main outcome measures Comparisons of 24 h urine excretion of Tc-99m DTPA we re made between the groups of cirrhotics and controls, different grades of cirrhosis (according to Child-Pugh criteria), alcoholic and nonalcoholic ci rrhotics and cirrhotic patients with and without SEP. Results Patients with cirrhosis excreted Tc-99m DTPA significantly more tha n controls (11.56 +/- 8.96% in cirrhotics and 4.30 +/- 1.49% in controls, P < 0.0001). There was no relationship of 24 h urine excretion of the tracer with the grade and aetiology of cirrhosis (12.20 +/- 9.47%, 11.41 +/- 9.84 %, and 11.09 +/- 8.42%, in Child A, B, and C groups and 8.45 +/- 6.57% and 12.05 +/- 9.25% in alcoholic and non-alcoholic cirrhotics, respectively). N o significant difference was found between cirrhotic patients with and with out SEP in terms of excretion of the administered dose of Tc-99m DTPA (9.98 +/- 9.47% and 12.20 +/- 8.82%, respectively). Conclusions This study shows that intestinal permeability increased in cirr hotic patients regardless of the grade and aetiology of disease. The presen ce of SEP does not seem to be due to increased intestinal permeability. Eur J Gastroenterol Hepatol 11:409-412 (C) 1999 Lippincott Williams & Wilkins.