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Intestinal Permeability in Irritable Bowel Syndrome Patients: Effects of NSAIDs

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Abstract

Intestinal permeability and the effect of NSAIDs on permeability were investigated in 14 irritable bowel syndrome (IBS) patients and 15 healthy subjects. In the study, 24-h urinary recoveries of orally administered polyethylene glycols (PEGs 400, 1500, and 4000) were not significantly different in healthy subjects and IBS patients before or after NSAID ingestion. Lactulose mannitol ratios in healthy subjects and IBS patients were not significantly different. Only time-dependent monitoring of PEG excretion showed that NSAIDs enhanced intestinal permeability for PEG 4000 in healthy subjects (P = 0.050) and for PEGs 400, 1500, and 4000 in IBS patients (P = 0.012, P = 0.041, and P = 0.012, respectively). These results show that intestinal permeability in IBS patients is not different from that in healthy subjects; NSAIDs compromise intestinal permeability in IBS patients to a greater extent than in healthy subjects, which suggests that IBS is associated with an altered response of the intestinal barrier to noxious agents.

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Acknowledgments

We acknowledge the staff of the Department of Pharmacy of the UMC Utrecht for production and supply of PEG and L/M test solutions. We thank M. van Loon, BSc, R. Voorbij, PhD, and coworkers of the Central Diagnostic Laboratory of the UMC Utrecht for the measurements of lactulose, mannitol, and creatinine. This work was funded in part by a Gastrostart grant from the Netherlands Society of Gastroenterology. APM Kerckhoffs was financially supported by Numico Research BV. LMA Akkermans received financial support from AstraZeneca R&D, Mölndal, Sweden. Supporting institutions were not involved in design, performance, or publication of this study.

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Authors and Affiliations

  1. Gastrointestinal Research Unit of Departments of Gastroenterology, University Medical Center Utrecht, Heidelberglaan 100, F02.618, Utrecht, 3584CX, The Netherlands

    Angèle P. M. Kerckhoffs & Melvin Samsom

  2. Gastrointestinal Research Unit of Departments of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands

    Louis M. A. Akkermans, Martin B. M. de Smet, Marc G. H. Besselink, Falco Hietbrink & Willem Renooij

  3. Department of Pharmacy, University Medical Center Utrecht, Utrecht, The Netherlands

    Imke H. Bartelink

  4. Center for Biostatistics, Utrecht University, Utrecht, The Netherlands

    Wim B. Busschers

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  1. Angèle P. M. Kerckhoffs
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Correspondence to Angèle P. M. Kerckhoffs.

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Kerckhoffs, A.P.M., Akkermans, L.M.A., de Smet, M.B.M. et al. Intestinal Permeability in Irritable Bowel Syndrome Patients: Effects of NSAIDs. Dig Dis Sci 55, 716–723 (2010). https://doi.org/10.1007/s10620-009-0765-9

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