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Abstract
The noninvasive assessment of intestinal permeability in humans has a 20-year history.
Because the tests are increasingly used in clinical practice and research and because
there is much controversy, we reviewed the literature and outlined the potential and
possible shortcomings of these procedures. Data was obtained from personal files and
from a systemic search through MEDLINE and EMBASE. The principle of the differential
urinary excretion of orally administered test markers is explained with reference
to the desired physicochemical properties of the markers and how the principle can
be exploited to allow assessment of various other gastrointestinal functions. The
use of intestinal permeability tests for diagnostic screen for small bowel disease
and assessment of responses to treatment, the pathogenesis of disease, normal intestinal
physiology, and the effect of drugs and toxins on the intestine is described and reviewed.
The controversy surrounding the anatomic location of the permeation pathways that
the markers use is highlighted. Noninvasive tests of intestinal permeability have
fulfilled early promises of usefulness in clinical practice and research. There is
now a need for integrated research into the basic mechanisms of regulatory control
of the intestinal barrier function.