Assessment of intestinal permeability with a two-hour urine collection

Sharmeen Akram, Samir Mourani, Ching Nan Ou, Cheryl Rognerud, Raheela Sadiq, Richard W. Goodgame

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


The differential urinary excretion of orally administered lactulose and mannitol is used to evaluate intestinal permeability. This test usually involves a 5- to 6-hr urine collection. We hypothesized that a shorter collection time would give an equivalent result. Forty-three patients with a variety of gastrointestinal symptoms and diagnoses (group 1) and 42 patients with Crohn's disease (group 2) had a standard lactulose/mannitol permeability test. The lactulose and mannitol urinary excretion was calculated using the first urine (group 1) or the 1-hr and 2-hr urine (group 2) and was compared to the values calculated from the routine 5-or 6-hr collection. Lactulose excretion kinetics, expressed as the percent of the total urinary excretion within a given time period, were as follows: 21% in first hour (group 2), 29% in second hour (group 2), and 46% in first 2.5 hr (group 1). Mannitol urinary excretion kinetics were 16%, 31%, and 44%, respectively. The lactulose/mannitol ratio based on a standard urine collection correlated well with the ratio based on just the first urine produced by the patient (R2 = 0.94; P < 0.001; group 1) and the 2-hr urine (R2 = 0.464; P < 0.001; group 2). Future use of the lactulose/mannitol ratio to assess intestinal permeability may be able to be simplified by shortening the urine collection time.

Original languageEnglish (US)
Pages (from-to)1946-1950
Number of pages5
JournalDigestive Diseases and Sciences
Issue number9
StatePublished - 1998
Externally publishedYes


  • Intestinal permeability
  • Lactulose
  • Mannitol
  • Mucosal permeability
  • Small intestine

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology


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