Lymphocytic gastritis and gastric permeability in patients with celiac disease.

BACKGROUND & AIMS: Lymphocytic gastritis is associated with celiac disease. Gastric permeability can now be assessed by a sucrose test, and intestinal permeability measured by a lactulose/mannitol test is increased in untreated celiac patients. The aim of this study was to prospectively compare gastric and intestinal permeability with histological changes of the stomach and small bowel in patients with celiac disease.

METHODS

Gastric and intestinal permeability were measured by oral or duodenal (during endoscopy) administration of a triple sugar solution containing 20 g sucrose, 10 g lactulose, and 5 g mannitol in 100 mL water in 43 adult patients with celiac disease (28 without diet) and in 30 healthy controls. Endoscopical biopsy specimens were taken from the antrum and distal duodenum and investigated for intraepithelial lymphocyte counts.

RESULTS

Urinary sucrose excretion decreased after duodenal administration (n = 8) as opposed to oral administration and thus measured gastric permeability in celiac disease. Gastric permeability was elevated in 60% of the celiac patients and correlated with antral intraepithelial lymphocyte counts. Intestinal permeability (measured by a lactulose/mannitol test) was also elevated in 69% of the celiac patients and correlated with duodenal intraepithelial counts.

CONCLUSIONS

There is a high prevalence of lymphocytic gastritis in untreated celiac disease associated with elevated gastric permeability. Celiac disease seems to be a general disorder of the gastrointestinal tract associated with disturbed permeability.