rss
Gut 1999;44:483-489 doi:10.1136/gut.44.4.483
  • Small intestine

Geography of intestinal permeability and absorption

  1. I S Menzies*,b,
  2. M J Zuckermanc,
  3. W S Nukajamb,
  4. S G Somasundarama,
  5. B Murphya,
  6. A P Jenkinsb,
  7. R S Cranea,
  8. G G Gregoryd
  1. aDepartment of Clinical Biochemistry, King’s College School of Medicine and Dentistry, Bessemer Road, London SE5 9PJ, UK, bSt Thomas’s Hospital, Lambeth Palace Road, London SE1 7EH, UK, cDepartment of Medicine, Texas Tech University Health Sciences Centre, 4800 Alberta Avenue, El Paso, Texas 79905, USA, dDepartment of Mathematical Sciences, University of Texas at El Paso, El Paso, Texas 79968, USA
  1. Dr Zuckerman.
  • Accepted 15 October 1998

Abstract

BACKGROUND Intestinal morphology and function vary geographically.

AIMS These functions were assessed in asymptomatic volunteers in European, North American, Middle Eastern, Asian, African, and Caribbean countries.

METHODS Five hour urine collections were obtained from each subject following ingestion of a 100 ml iso-osmolar test solution containing 3–0-methyl-d-glucose,d-xylose, l-rhamnose, and lactulose after an overnight fast, to assess active (3–0-methyl-d-glucose) and passive (d-xylose) carrier mediated, and non-mediated (l-rhamnose) absorption capacity, as well as intestinal permeability (lactulose:rhamnose ratio).

RESULTS A comparison of results for subjects from tropical countries (n=218) with those resident in the combined temperate and subtropical region (Europe, United States, Qatar) (n=224) showed significant differences. Residents in tropical areas had a higher mean lactulose:rhamnose ratio and lower mean five hour recoveries of 3–0-methyl-d-glucose,d-xylose, and l-rhamnose, indicating higher intestinal permeability and lower absorptive capacity. Investigation of visiting residents suggested that differences in intestinal permeability and absorptive capacity were related to the area of residence. Subjects from Texas and Qatar, although comprised of several ethnic groups and resident in a subtropical area, showed no significant difference from European subjects.

CONCLUSIONS There are clearly demarcated variations in intestinal permeability and absorptive capacity affecting asymptomatic residents of different geographical areas which correspond with the condition described as tropical enteropathy. Results suggest the importance of environmental factors. The parameters investigated may be relevant to the predisposition of the indigenous population and travellers to diarrhoeal illness and malnutrition. Intestinal function in patients from the tropics may be difficult to interpret, but should take into account the range of values found in the asymptomatic normal population.

Footnotes

  • ↵* Present address: King’s College School of Medicine and Dentistry, Bessemer Road, London SE5 9PJ, UK

  • Abbreviations:
    GDP
    gross domestic product

This Article

  1. Abstract
  2. Full text
  3. PDF

Register for free content

The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.