Intestinal permeability, mucosal injury, and growth faltering in Gambian infants

Lancet. 1991 Oct 12;338(8772):907-10. doi: 10.1016/0140-6736(91)91772-m.


There is controversy over whether children in developing countries can catch up on their growth rates after bouts of diarrhoea. A factor influencing catch-up growth is the extent and duration of mucosal injury. To explore the relation between intestinal disease and growth performance, a non-invasive test of intestinal integrity, the lactulose:mannitol permeability test, was done regularly on children aged 2-15 months, whose growth was monitored over a mean of 7.5 months. The study revealed persistent abnormalities in the small bowel mucosa of 2-15 month old Gambian infants and a negative correlation between these abnormalities and growth. Up to 43% of observed growth faltering can be explained on the basis of these long-term intestinal lesions.

MeSH terms

  • Body Height
  • Body Weight
  • Diarrhea, Infantile / complications*
  • Gambia
  • Growth Disorders / etiology*
  • Growth Disorders / physiopathology
  • Humans
  • Infant
  • Intestinal Absorption / physiology*
  • Intestinal Mucosa / physiopathology*
  • Lactulose
  • Mannitol
  • Prospective Studies
  • Rural Health


  • Mannitol
  • Lactulose