Gastric permeability to sucrose is increased in portal hypertensive gastropathy

Background Portal hypertensive gastropathy (PHG) is frequently found among patients with hepatic cirrhosis and at present the only way to detect and f ollow PHG is via endoscopy. Objective To assess gastric and intestinal permeability and investigate its relationship to endoscopic findings and indices of portal hypertension and hepatic function. Design and methods Thirty-one non-diabetic patients with hepatic cirrhosis and PHG (PHG+) were studied and compared with 17 cirrhotic patients without PHG (PHG-), All patients underwent endoscopy for the assessment of PHG and Helicobacter pylori status, ultrasound determination of the diameters of s pleen and portal vein, and, subsequently, an oral load of sucrose, lactulos e, and mannitol. Sugar concentrations were determined in 6-h urine specimen s and expressed as a percentage of the orally administered dose or as lactu lose/mannitol ratio. Results The urinary sucrose excretion was significantly elevated in patient s with PHG compared to those without (PHG+, 0.20% +/- 0.03; PHG-, 0.07% +/- 0.01; P < 0.001). No difference was found for the small intestinal probes lactulose and mannitol, Gastric sucrose permeability correlated positively with the endoscopic lesion score (P < 0.001), but not with other parameters of portal hypertension or hepatic function. H. pylori status did not influ ence gastric permeability. The sensitivity of this test reached 100% for PH G scores > 2. Conclusions Gastric permeability to sucrose is increased in patients with P HG, independently of the presence of H. pylori. Sucrose permeability may be useful for the followup of patients with PHG. (C) 2000 Lippincott Williams & Wilkins.