Intestinal permeability in cirrhotic patients with and without ascites

Introduction Patients with liver cirrhosis are at high risk of developing complications. Vulnerability to the bacterial infections in those patients is owing to numerous anomalies in defense mechanisms. Increased permeability of intestine may cause translocation of bacteria, endotoxins, and pathogen-associated molecular patterns into the portal tract and other sites. Objective The purpose of this study was assessment and evaluation of permeability of intestine in patients with liver cirrhosis with and without ascites. Patients and methods This study involved 50 patients with liver cirrhosis, comprising 25 with ascites and 25 without ascites. Permeability of intestine was detected by lactulose and mannitol ratio. The lactulose and mannitol were given orally in 100 ml of water and then patient's urine was obtained for the next 5 h. Determination of lactulose and mannitol in urine was entirely done by enzymatic methods. Results The study showed significant impairment of permeability of intestine in cirrhotic patients compared with controls. From 50 cirrhotic patients, permeability of intestine was impaired in 32 (64%) patients, representing one (3%) patient with Child A, 10 (31%) patients with Child B, and 21 (65%) patients with Child C, and permeability was normal in 18 (36%) cirrhotic patients. Conclusion Permeability of intestine was impaired in cirrhotic patients and the degree of impairment is related to the severity of disease, which increased the risk of complications.