Intestinal permeability changes in response to acetylsalicylic acid in relatives of patients with Crohn's disease

Gastroenterology. 1996 May;110(5):1395-403. doi: 10.1053/gast.1996.v110.pm8613043.


Background & aims: Presence of a familial intestinal permeability defect in Crohn's disease remains controversial despite numerous studies. The purpose of this study was to determine whether detection of a permeability defect in first-degree relatives of patients with Crohn's disease can be enhanced using an acetylsalicylic acid provocation test.

Methods: Lactulose-mannitol ratio, a measure of intestinal permeability, and total sucrose excretion, a measure of gastroduodenal permeability, were determined before and after ingestion of acetylsalicylic acid in healthy controls, in patients with Crohn's disease, and in the first-degree relatives of patients with Crohn's disease. Subjects were classified as hyperresponders if their results were above the mean of + 2SD of the controls.

Results: First-degree relatives had a 110% increase in intestinal permeability after acetylsalicylic acid compared with an increase of 57% in controls (P = 0.001). Thirty-five percent of relatives were classified as hyperresponders. There was no significant difference in the change in sucrose excretion between relatives and controls (259% vs 198%; P < 0.05).

Conclusions: First-degree relatives of patients with Crohn's disease have an exaggerated increase in intestinal but not gastroduodenal permeability in response to acetylsalicylic acid. This study supports a familial permeability defect in Crohn's disease, which may not be present in all families.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal*
  • Aspirin*
  • Crohn Disease / genetics
  • Crohn Disease / metabolism*
  • Crohn Disease / urine
  • Duodenum / drug effects
  • Duodenum / metabolism
  • Family Health
  • Female
  • Gastric Mucosa / metabolism
  • Humans
  • Intestinal Mucosa / metabolism
  • Intestines / drug effects*
  • Lactulose / urine
  • Male
  • Mannitol / urine
  • Pedigree
  • Permeability / drug effects
  • Stomach / drug effects
  • Sucrose / urine


  • Anti-Inflammatory Agents, Non-Steroidal
  • Mannitol
  • Lactulose
  • Sucrose
  • Aspirin