Gut permeability in patients with acute pancreatitis

Background: The bacterial contamination of pancreatic necrosis in acute pan creatitis is supposed to occur through translocation of intestinal bacteria . Increased gut permeability may be the initial phenomenon in this process. To test the hypothesis that gut permeability is increased in acute pancrea titis a clinical study was made where gut absorption and permeability were assessed with multi-sugar probes in patients with acute pancreatitis within 2 days after admission to hospital and again after recovery of disease, Me thods and Results: Twenty-three patients with acute pancreatitis and 20 hea lthy controls were studied. According to Atlanta classification, 15 patient s had mild and 8 patients severe pancreatitis. Gut absorption, assessed as the 5-h urine excretion of L-rhamnose, D-xylose and 3-O-methylglucose, was decreased in patients with acute pancreatitis and more pronounced in patien ts with severe pancreatitis (L-rhamnose and D-xylose: P < 0.001, 3-O-methyl glucose: P < 0.0.5). Gut permeability, assessed as the ratio of lactulose/L -rhamnose, was increased in severe pancreatitis (0.16 +/- 0.13, 0.07 +/- 0. 03, 0.04 +/- 0.04: severe pancreatitis, mild pancreatitis, controls, respec tively; P < 0.001 between three groups, P < 0.05 between pancreatitis group s). Conclusions: Gut absorption capacity is decreased and gut permeability is increased in patients with acute pancreatitis. Patients with severe panc reatitis may be more exposed to impaired gut barrier function.