A Study Of Intestinal Permeability In Patients With Liver Cirrhosis

Abstract

This study included 46 adult patients with liver cirrhosis, 24 males and 22 females. They were admitted to the department of Tropical Medicine and Gastroenterology, Assiut University Hospital. Their ages ranged from 20-70 years with a mean of 36.2 years. Another group of 12 age matched normal individuals as a control group were studied. The adiagnosis was done by clinical, ultrasonographic, biochemical and endoscopic criteria.

According to modified Child-Pugh classification, the patients were divided into 3 groups, 12 patients of Child class A, 15 patients of Child class B and 19 patients of Child class C.

Thirtyfour patients had portal hypertension, 6 patients had SBP and 10 patients had hepatic encephalopathy "2 of them had hepato­ cellular carcinoma".

Studies for intestinal mucosal permeability were done for patients and control groups using 5 hours urinary excretion ratio of lactulose and L-rhamnose. Lactulose permeation across the intestinal mucosa occures exclusively through the intercellular tight junctions via the paracellular pathway. Less than (1%) of the ingested lactulose permeates the intestinal mucosa and appears in the urine. L-rhamnose permeates the intestinal mucosa mainly via the transcellular pathway through the smaller water filled, aqueous pores in the enterocyte cell. walls, that larger molecules, such as lactulose, cannot penetrate.