|Mcomber, Mark -|
|Shulman, Robert -|
Submitted to: Gastroenterology
Publication Type: Abstract Only
Publication Acceptance Date: April 1, 2009
Publication Date: May 1, 2009
Citation: McOmber, M.E., Shulman, R.J. 2009. Gastrointestinal permeability (GIPerm) is increased in family members of children with functional abdominal pain (FAP) and irritable bowel syndrome (IBS) [abstract]. Gastroenterology. 136(5 Suppl.1):A154-A155. Technical Abstract: Increased GIPerm has been described in children with FAP/IBS and adults with IBS. We sought to determine if baseline GIPerm is increased and if ibuprofen induces a greater increase in GIPerm in parents and siblings of children with FAP/IBS vs. control families without children with FAP/IBS. Site specific GIPerm testing was carried out in two groups of families: 1) parents and siblings of children previously identified as having FAP or IBS, and 2) parents and their children with no history of FAP or IBS in the children (Controls). Parents and children ingested a solution containing sucrose (10 g/dL), lactulose (5 g/dL), mannitol (1 g/dL), and sucralose (1 g/dL) after a 4 h fast following the evening meal. Urine was collected for 24 h. Percent recovery of the sugars and sugar ratios were calculated: 1) from the time of ingestion through the first morning urine (overnight), and 2) after the first morning urine through 24 h after ingestion (day/evening), and 3) for the entire 24 h period. In the adults, the GIPerm test was repeated following the ingestion of 400 mg of ibuprofen every 8 hr for 3 doses. Data were log transformed for analysis. n=23 FAP/IBS families (14 fathers, 22 mothers, 21 children) and n=14 Control families (7 fathers, 14 mothers, 18 children). In children, controlling for age, sex, and family, overnight gastric (% sucrose recovery), and gastric/proximal bowel (sucrose/lactulose ratio) GIPerm were greater in siblings of FAP/IBS children than in Controls (Gastric: 0.08 ± 1.2 vs. 0.02 ± 1.2, P<0.0005; Proximal: 0.28 ± 1.22 vs. 0.11 ± 1.42, respectively, P=0.03; mean ± SE). There were no differences in small intestinal or colonic permeability. In parents, controlling for age, sex, and family, there were no differences in baseline GIPerm. In contrast, controlling for baseline value, age, sex, and family, after ibuprofen administration GIPerm increased more in the parents of FAP/IBS children than in the Control parents (day/evening Gastric: 0.14 ± 1.22 vs. 0.04 ± 1.28, respectively, P<0.0005; Proximal: 2.28 ± 1.47 vs. 0.34 ± 1.43, P=0.001). Similar differences were noted for the 24 h period. Small intestinal and colonic permeability were similar between parent groups. Compared to Controls: 1) Siblings of children with FAP/IBS have evidence of increased gastric and proximal small bowel permeability , and 2) Parents of children with FAP/IBS respond to ibuprofen administration with a greater increase in GIPerm than Control parents, and 3) use of extended collection periods increases the ability to detect differences in GIPerm.