Lactulose-L-rhamnose intestinal permeability test in patients with liver cirrhosis

A lactulose-L-rhamnose intestinal permeability test was conducted on 35 pat ients with liver cirrhosis and six normal controls. Gas chromatography was used to measure lactulose and L-rhamnose concentrations in blood and urine specimens. The excretion of each molecule was expressed as the percentage o f the orally administrated dose and the lactulose-L-rhamnose ratio as the r atio of the percentage of each probe molecule excreted. The mean 8-h lactul ose excretion ratios were 0.56 and 0.16% in patients with liver cirrhosis a nd the control subjects, respectively (P < 0.05), whereas the corresponding excretion ratios for L-rhamnose were 4.40 and 3.49%. The mean lactulose-L- rhamnose excretion ratios in patients with liver cirrhosis and the control subjects were 0.124 and 0.049, respectively (P < 0.05). The lactulose-L-rha mnose excretion ratio increased in patients with liver cirrhosis complicate d by large intestinal vascular ectasia of the large intestine or rectal var ices, which were used as parameters for evaluating the effects of portal hy pertension on the lower digestive tract. These results suggest that an incr ease in lactulose intestinal permeability in patients with liver cirrhosis proves the effects of portal hypertension extending to the lower digestive tract. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.