Measurement of intestinal permeability using mannitol and lactulose in children with diarrheal diseases

Braz J Med Biol Res. 1999 Dec;32(12):1499-504. doi: 10.1590/s0100-879x1999001200008.


The excretion ratio of lactulose/mannitol in urine has been used to assess the extension of malabsorption and impairment of intestinal permeability. The recovery of lactulose and mannitol in urine was employed to evaluate intestinal permeability in children with and without diarrhea. Lactulose and mannitol probes were measured using high-performance liquid chromatography with pulsed amperometric detection (HPLC-PAD). Two groups of solutions containing 60 microM sugars were prepared. Group I consisted of glucosamine, mannitol, melibiose and lactulose, and group II of inositol, sorbitol, glucose and lactose. In the study of intra-experiment variation, a sample of 50 microl from each group was submitted to 4 successive determinations. The recovered amounts and retention times of each sugar showed a variation <2 and 1%, respectively. The estimated recovery was >97%. In the study of inter-experiment variation, we prepared 4 independent samples from groups I and II at the following concentrations: 1.0, 0.3, 0.1, 0.03 and 0.01 mM. The amounts of the sugars recovered varied by <10%, whereas the retention times showed an average variation <1%. The linear correlation coefficients were >99%. Retention (k'), selectivity (alpha) and efficiency (N) were used to assess the chromatographic conditions. All three parameters were in the normal range. Children with diarrhea presented a greater lactulose/mannitol ratio compared to children without diarrhea.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Child, Preschool
  • Chromatography, High Pressure Liquid
  • Diarrhea / metabolism
  • Diarrhea / physiopathology*
  • Diuretics, Osmotic / urine*
  • Gastrointestinal Agents / urine*
  • Humans
  • Intestinal Absorption / physiology*
  • Lactulose / urine*
  • Mannitol / urine*


  • Diuretics, Osmotic
  • Gastrointestinal Agents
  • Mannitol
  • Lactulose