Z Gastroenterol 2009; 47 - A25
DOI: 10.1055/s-0029-1224004

Gut permeability in patients with irritable bowel syndrome and inactive ulcerative colitis

K Gecse 1, R Róka 1, T Séra 2, A Annaházi 3, A Rosztóczy 1, F Izbéki 1, T Molnár 1, F Nagy 1, L Pávics 2, L Bueno 3, T Wittmann 1
  • 1First Department of Medicine, University of Szeged, Hungary
  • 2Department of Nuclear Medicine, University of Szeged, Hungary
  • 3Neuro-Gastroenterology and Nutrition Unit, INRA, Toulouse, France

Introduction: Elevated colonic permeability has previously been reported in our preliminary study in the diarrhea-predominant subgroup of patients with irritable bowel syndrome (IBS-D). There is growing evidence for low grade mucosal inflammation in IBS, therefore comparing permeability data on inflammatory bowel disease and IBS may be an interesting issue of future investigations concerning the pathomechanism of IBS.

Aims: The aim of this study was to evaluate gut permeability in patients with inactive ulcerative colitis in comparison with subgroups of IBS patients and control subjects.

Methods: IBS patients of the diarrhea (n=18; mean age±SEM: 45.9±3.5) and of the constipation subgroup (IBS-C, n=12; mean age±SEM: 56.2±2.5) fulfilling the Rome III criteria were studied and patients with inactive ulcerative colitis were also involved (n=13; mean age±SEM: 47.4±3.6). A group of healthy subjects (n=10; mean age±SEM: 48.8±2.9) served as controls. Gut permeability was evaluated by measuring 24-hour urine excretion of orally administered 51Cr-EDTA in three different containers, where time periods were chosen to relate to permeability within the proximal and distal small intestine and the large bowel.

Results: There was a significant difference in the proximal small intestinal permeability in IBS-C patients compared to controls (0.26±0.05 vs. 0.63±0.1%; p<0.05). Gut permeability did not show any significant difference in the distal small intestine in subgroups of IBS patients, and UC patients compared to control subjects. Colonic permeability of IBS-C patients remained as low (0.69±0.12%), as those of control subjects, showing no significant difference. However, colonic permeability of IBS-D patients and especially patients with inactive ulcerative colitis proved to be significantly higher compared to healthy controls (2.68±0.35 and 3.74±0.49 vs. 1.04±0.18%; p<0.05, p<0.001, respectively).

Conclusion: In our present study, we have shown that colonic permeability of both IBS-D and UC patients in remission are significantly elevated compared to those of controls.