Lactulose Mannitol Test and Intestinal Permeability

Dig Dis Sci. 2008 Mar 5 [Epub ahead of print]

Lactulose/Mannitol Test and Specificity, Sensitivity, and Area under Curve of Intestinal Permeability Parameters in Patients with Liver Cirrhosis and Crohn's Disease.

Dastych M, Dastych M Jr, Novotná H, Cíhalová J. Department of Clinical Biochemistry and Hematology, University Hospital Brno, Jihlavská 20, 62500, Brno, Czech Republic, mdast@fnbrno.cz.

The purpose of this study was to investigate and compare the specificity, sensitivity, and area under curve (AUC) of the lactulose/mannitol ratio, lactulose/creatinine ratio, and lactulose recovery and their diagnostic value for intestinal permeability assessment within the absorption lactulose/mannitol (L/M) test. Results The value of the lactulose/mannitol ratio, lactulose/creatinine ratio, and the percentage of lactulose recovery in Crohn's disease (0.0763 +/- 0.0369; 99.62 +/- 67.87; 1.0478 +/- 0.6148) and in liver cirrhosis (0.0517 +/- 0.0365; 54.65 +/- 53.26; 0.838 +/- 0.929) were significantly different from the values measured in the control group (0.0123 +/- 0.0081; 10.95 +/- 7.07; 0.2438 +/- 0.1568), P < 0.0001-0.002). In Crohn's disease, specificity, sensitivity, and AUC were 100%, 89.5%, and 0.987, respectively, of the lactulose/mannitol ratio at a cut-off level of 0.022. In liver cirrhosis, the test characteristics were 88.5%, 84.2%, and 0.910 at a cut-off level of 0.018. Conclusion The lactulose/mannitol ratio was evaluated to have the highest diagnostic value to assess intestinal permeability.

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written by ann, May 22, 2009

Where can I get the Lactulose & Mannitol test done and interpreted in the central florida area. None of my doctors seem to know anything about it and I'm very sure (minus the test) that I have Leaky Gut.
Please help.
Ann
Florida
Lave12752@yahoo.com

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written by Maff, May 22, 2009

Hi Ann,

Tests for leaky gut syndrome (or "increased intestinal permeability") are not widely used by conventional doctors as yet so are not provided on a local level. There are a number of labs in the US however that do provide the Lactulose/Mannitol Assessment to test for leaky gut syndrome. The one I am most familiar with is Genova Diagnostics (formerly Great Smokies Diagnostic Lab). The page on their website for the Lactulose/Mannitol Assessment is at - http://www.genovadiagnostics.c...nav=&id=18

All you do for the test is collect a few urine samples before and after drinking a solution containing lactulose and mannitol, then post the samples to the lab. You will most likely need to find a doctor, nutritionist, or other alternative medicine practitioner in your area who is already familiar with the lab and the test. You can check the Health Care Professional Directory or post in the forums to see if any other visitors know of someone in your area.

Hope this helps!

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written by robyn, July 02, 2009

Can you explain in lay person's terms what it means when the test shows Lactose recovery 0.32 if the range is 0.00- 0.30
I can see that it is high but how is playing out in my gut?

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written by Maff, July 02, 2009

Hi Robyn,

Yes you're correct that your lactulose result is slightly high. What this means is that you likely have a mild case of leaky gut syndrome.

High lactulose results mean that large particles from your gut are passing between the cells that line the intestines and being absorbed into your body. These particles could be incompletely digested food or gut microbes such as the common yeast Candida, or various species of bacteria (either whole or parts of dead organisms). The result is that your immune system will react to all of this stuff entering your system and cause inflammatory reactions. Increased intestinal permeability (leaky gut syndrome) has been associated with many allergic and autoimmune disorders such eczema and rheumatoid arthritis. The absorption of these things that should remain in your gut also puts extra strain on your liver which has to detoxify all the extra toxins absorbed. An overloaded liver can cause symptoms from digestive upsets to fatigue and generally feeling unwell.

It is best to work with a nutritionally oritentated doctor or an alternatibe medicine practitioner (naturopath, nutritionist, herbalist) to help you treat this problem.

Please start by having a look at the leaky gut syndrome treatment page on this site and search elsewhere on the internet. There is a lot of information out there. Good luck!