Permeability of the Gut in the Diagnosis of Coeliac Disease in Adults and Monitoringof Adherence to a Gluten-free Diet by these Patients

Overview

The author examined the gut permeability using the test with lactulose, mannitol and D-xylose in patientswith coeliac disease. The investigation comprised 30 patients with coeliac disease before they started a glutenfree diet. As control group served 30 patients without organic affliction of the digestive tract. Intestinalpermeability is significantly greater when using the indexes lactulose/mannitol and lactulose/D-xylose inpatients with untreated coeliac disease. In 23 patients the authors followed-up the value of intestinal permeability before the gluten-free diet and 2–6 months after adherence to the diet (checked by reduction ornormalization of antibodies against gliadin, and/or endomysin and reticulin). The value of gut permeabilityassessed by indexes lactulose/mannitol and lactulose/D-xylose declined significantly, however, they did notreach normal values. The test of intestinal permeability is a suitable supplement, a noninvasive test in thediagnosis of coeliac disease and monitoring of compliance of gluten-free diet.

Key words:
coeliac disease – gluten-free diet – intestinal permeability – lactulose – mannitol – D-xylose