Intestinal Permeability

Changes in intestinal permeability are associated with many health conditions including autism, autoimmune disorders, food sensitivities and inflammatory bowel disease. This ‘leaky gut’ causes disease because the perturbed intestinal barrier allows toxic molecules to enter the bloodstream and poison the body.  Intestinal permeability can be measured using the lactulose/mannitol test. Consider this test for the assessment of intestinal permeability and malabsorption.

The intestinal permeability test which assesses lactulose and mannitol recovery can be used to monitor improvements or deterioration in intestinal permeability as a result of therapy, disease or drug use.  Furthermore, the intestinal permeability test has been used to monitor the compliance and effectiveness of a gluten-free diet in patients with Coeliac disease.

The test works on the principle that small molecules (i.e. mannitol) are readily absorbed by the intestinal villi, whilst larger molecules such as disaccharides (i.e. lactulose) are not. These water soluble non-metabolised sugar molecules after penetrating the intestinal tract are excreted into the urine.  Under normal circumstances the ratio of lactulose to mannitol in urine is low (i.e lactulose is not absorbed), mannitol is absorbed.  When the structure of the intestinal epithelium is jeopardised (‘leaky gut’ is present), the large sugar molecule can permeate the mucosa and is recovered in the urine.  In this situation the level of lactulose is increased in the urine and therefore the ratio of lactulose to mannitol is high.

In addition to assessing leaky gut, this test can also help identify malabsorption.  If a low level of mannitol which normally penetrates the intestinal epithelium is observed, it may indicate malabsorption of small molecules and possible atrophy of the intestinal villi.

Test details

• Test code: 2011
• Category: Microbiome Health
• Kit requirements: IP Test Kit - Urine
• Collection method: CI05.08.01
• Test method: GCMS (Gas chromatography mass-spectrometry)
• Turnaround time: 5 Business Days

What is measured

• Lactulose (recovery %)
• Lactulose:Mannitol ratio
• Mannitol (recovery %)

Common clinical applications

• Other Health Conditions
  • Fatigue
  • Food allergy and sensitivities
  • Gut dysbiosis
  • Inflammatory Bowel Disease – Ulcerative colitis, Crohn’s disease, Coeliac
  • Irritable Bowel Syndrome

Resources

• Patient Brochure
• Sample Report

This test should be ordered and interpreted with guidance from a qualified healthcare practitioner.

Important: Test information is general only. Results should be interpreted with a qualified health practitioner and do not replace medical advice or diagnosis.