{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:28:43Z","timestamp":1790310523370,"version":"4.1.0"},"reference-count":16,"publisher":"BMJ","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1993,3]]},"abstract":"<jats:p>The functional integrity of the small bowel is impaired in coeliac disease. Intestinal permeability, as measured by the sugar absorption test probably reflects this phenomenon. In the sugar absorption test a solution of lactulose and mannitol was given to the fasting patient and the lactulose\/mannitol ratio measured in urine collected over a period of five hours. The sugar absorption test was performed in nine patients with coeliac disease with an abnormal jejunum on histological examination, 10 relatives of patients with coeliac disease with aspecific symptoms but no villous atrophy, six patients with aspecific gastrointestinal symptoms but no villous atrophy, and 22 healthy controls to determine whether functional integrity is different in these groups. The lactulose\/mannitol ratio (mean (SEM) is significantly higher in both coeliac disease (0.243 (0.034), p &lt; 0.0001)) and relatives of patients with coeliac disease (0.158 (0.040), p &lt; 0.005)) v both healthy controls (0.043 (0.006)) and patients with aspecific gastrointestinal symptoms (0.040 (0.011)). The lactulose\/mannitol ratio in relatives of coeliac disease patients was significantly lower than in the coeliac disease patient group (p = 0.04). The lactulose\/mannitol ratio was the same in healthy controls and patients with aspecific gastrointestinal symptoms. It is concluded that the sugar absorption test is a sensitive test that distinguishes between patients with coeliac disease and healthy controls. The explanation for the increased permeability in relatives of patients with coeliac disease is uncertain. Increased intestinal permeability may be related to constitutional factors in people susceptible to coeliac disease and may detect latent coeliac disease. The sugar absorption test may therefore be helpful in family studies of coeliac disease.<\/jats:p>","DOI":"10.1136\/gut.34.3.354","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"354-357","source":"Crossref","is-referenced-by-count":146,"title":["Intestinal permeability in patients with coeliac disease and relatives of patients with coeliac disease."],"prefix":"10.1136","volume":"34","author":[{"given":"R M","family":"van Elburg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J J","family":"Uil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C J","family":"Mulder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H S","family":"Heymans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1993,3,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1111\/j.1651-2227.1990.tb11367.x","article-title":"Incidence and prevalence of coeliac disease in Tampere. Coeliac disease is not disappearing","volume":"79","author":"Maki, M.; Holm, K.","year":"1990","unstructured":"Maki M, Holm K. Incidence and prevalence of coeliac disease in Tampere. Coeliac disease is not disappearing. Acta Paediatr Scand 1990; 79: 980-2.","journal-title":"Acta Paediatr Scand"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1007\/BF02026721","article-title":"Is childhood coeliac disease underdiagnosed?","volume":"150","author":"Ceccarelli, M.; Caiulo, V.A.; Ughi, C.","year":"1991","unstructured":"Ceccarelli M, Caiulo VA, Ughi C. Is childhood coeliac disease underdiagnosed? [letter]. EurJ Pediatr 1991; 150: 821-2.","journal-title":"EurJ Pediatr"},{"key":"ref_3","first-page":"25","article-title":"Coeliac disease as a familial condition: identification of asymptomatic coeliac patients within","volume-title":"family groups. Gastroenterology International 1988; 1","author":"Auricchio, S.; Mazzacca, G.; Tosi, R.; Visakorpi, J.; Maki, M.; Polanco, I.","unstructured":"Auricchio S, Mazzacca G, Tosi R, Visakorpi J, Maki M, Polanco I. Coeliac disease as a familial condition: identification of asymptomatic coeliac patients within family groups. Gastroenterology International 1988; 1: 25-31."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/0016-5085(89)90767-1","article-title":"Lactulose\/mannitol test: an ideal screen for celiac disease","volume":"96","author":"Juby, L.D.; Rothwell, J.; Axon, A.T.R.","year":"1989","unstructured":"Juby LD, Rothwell J, Axon ATR. Lactulose\/mannitol test: an ideal screen for celiac disease. Gastroenterologv 1989; 96: 79-85.","journal-title":"Gastroenterologv"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1097\/00004836-198506000-00009","article-title":"Small intestinal permeability as an indicator of jejunal mucosal recovery in patients with celiac sprue on a gluten-free diet","volume":"7","author":"Ukabam, S.O.; Cooper, B.T.","year":"1985","unstructured":"Ukabam SO, Cooper BT. Small intestinal permeability as an indicator of jejunal mucosal recovery in patients with celiac sprue on a gluten-free diet. J Clin Gastroenterol 1985; 7: 232-6.","journal-title":"J Clin Gastroenterol"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1042\/bst0021042","article-title":"Absorption of intact oligosaccharides in health and disease","volume":"2","author":"Menzies, I.S.","year":"1974","unstructured":"Menzies IS. Absorption of intact oligosaccharides in health and disease. Biochem Soc Trans 1974; 2: 1042-7.","journal-title":"Biochem Soc Trans"},{"key":"ref_7","first-page":"527","article-title":"Transmucosal passage of inert molecules in health and disease","author":"Menzies, I.S.","year":"1983","unstructured":"Menzies IS. Transmucosal passage of inert molecules in health and disease. In: Skadhauge B, Heintze K, eds. Intestinal absorption and secretion. London: MTP Press, 1983: 527-43."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1016\/0016-5085(92)91819-P","article-title":"Gluten, major histocompatibility complex, and the small intestine. A molecular and immunobiologic approach to the spectrum of gluten sensitivity ('Celiac sprue')","volume":"102","author":"Marsh, M.N.","year":"1992","unstructured":"Marsh MN. Gluten, major histocompatibility complex, and the small intestine. A molecular and immunobiologic approach to the spectrum of gluten sensitivity ('Celiac sprue'). Gastroenterology 1992; 102: 330-54.","journal-title":"Gastroenterology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/0009-8981(86)90303-7","article-title":"Capilary gas chromatographic profyling of urinary, plasma derivates, preceded by a simple and rapid prepurification method","volume":"157","author":"Jansen, G.; Muskiet, F.A.J.; Schierbeek, H.; Berger, R.; Van der Slik, W.","year":"1986","unstructured":"Jansen G, Muskiet FAJ, Schierbeek H, Berger R, Van der Slik W. Capilary gas chromatographic profyling of urinary, plasma derivates, preceded by a simple and rapid prepurification method. Clin Chim Acta 1986; 157: 277-94.","journal-title":"Clin Chim Acta"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1097\/00005176-199004000-00002","article-title":"Intestinal permeability tests: are they clinically useful?","volume":"10","author":"Lifshitz, C.; Shulman, R.J.","year":"1990","unstructured":"Lifshitz C, Shulman RJ. Intestinal permeability tests: are they clinically useful? J Pediatr Gastroenterol Nutr 1990; 10: 283-7.","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"ref_11","first-page":"249","article-title":"Changes in mucosal function as determined by the D-xylose test and sugar absorption test","volume-title":"celiac disease. Gastroenterology 1992; 102","author":"Uil, J.J.; Van Elburg, R.M.; De Vries, R.A.; Mulder, C.J.J.; Heymans, H.S.A.","unstructured":"Uil JJ, Van Elburg RM, De Vries RA, Mulder CJJ, Heymans HSA. Changes in mucosal function as determined by the D-xylose test and sugar absorption test in celiac disease. Gastroenterology 1992; 102: A249."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1136\/gut.30.3.333","article-title":"Malignancy in coeliac disease-effect of a gluten free diet","volume":"30","author":"Holmes, G.K.T.; Prior, P.; Lane, M.R.; Pope, D.; Allan, R.N.","year":"1989","unstructured":"Holmes GKT, Prior P, Lane MR, Pope D, Allan RN. Malignancy in coeliac disease-effect of a gluten free diet. Gut 1989; 30: 333-8.","journal-title":"Gut"},{"key":"ref_13","first-page":"1445","article-title":"Comparison of different measurements of intestinal permeability in inflammatory bowel disease","volume":"86","author":"Howden, C.W.; Robertson, C.; Duncan, A.; Morris, A.J.; Russell, R.I.","year":"1991","unstructured":"Howden CW, Robertson C, Duncan A, Morris AJ, Russell RI. Comparison of different measurements of intestinal permeability in inflammatory bowel disease. AmJ7 Gastroenterol 1991;86: 1445-9."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1097\/00005176-198910000-00004","article-title":"Intestinal permeability to inert sugars and different-sized polyethyleneglycols in children with celiac disease","volume":"9","author":"Stenhammar, L.; Falth-Magnusson, K.; Jansson, G.; Magnusson, K.E.; Sundqvist, T.","year":"1989","unstructured":"Stenhammar L, Falth-Magnusson K, Jansson G, Magnusson KE, Sundqvist T. Intestinal permeability to inert sugars and different-sized polyethyleneglycols in children with celiac disease. J Pediatr Gastroenterol Nutr 1989; 9: 281-9.","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1097\/00005176-199105000-00001","article-title":"The controversy of the use of antigluten antibody (AGA) as a diagnostic tool in celiac disease (editorial)","volume":"12","author":"Lerner, A.; Lebenthal, E.","year":"1991","unstructured":"Lerner A, Lebenthal E. The controversy of the use of antigluten antibody (AGA) as a diagnostic tool in celiac disease (editorial). J Pediatr Gastroenterol Nutr 1991; 12: 407-9.","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1136\/gut.33.2.194","article-title":"Do adults with high gliadin antibody concentrations have subclinical glutenintolerance?","volume":"33","author":"Arnason, J.A.; Gudjonsson, H.; Freysdottir, J.; Jonsdottir, I.; Valdimarsson, H.","year":"1992","unstructured":"Arnason JA, Gudjonsson H, Freysdottir J, Jonsdottir I, Valdimarsson H. Do adults with high gliadin antibody concentrations have subclinical glutenintolerance? Gut 1992; 33: 194-7.","journal-title":"Gut"}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.34.3.354","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T15:15:03Z","timestamp":1765638903000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.34.3.354"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1993,3]]},"references-count":16,"journal-issue":{"issue":"3","published-online":{"date-parts":[[1993,3,1]]},"published-print":{"date-parts":[[1993,3]]}},"alternative-id":["10.1136\/gut.34.3.354"],"URL":"https:\/\/doi.org\/10.1136\/gut.34.3.354","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"value":"0017-5749","type":"print"},{"value":"1468-3288","type":"electronic"}],"subject":[],"published":{"date-parts":[[1993,3]]}}}