Intestinal permeability and diarrhoeal disease in Aboriginal Australians
R H Kukuruzovic, A Haase, K Dunn, A Bright, D R Brewster
NHMRC Centre of
Clinical Excellence in Aboriginal Health, NT Clinical School, Flinders
University and Royal Darwin Hospital, PO Box 41326, Casuarina, Darwin,
NT 0811, Australia
Correspondence to: Professor Brewster. email: David.Brewster{at}health.nt.gov.au
Accepted 28 May 1999
BACKGROUND
Northern
Territory Aboriginal children hospitalised with acute gastroenteritis
have high rates of acidosis, hypokalaemia, and dehydration.
AIMSTo determine
whether Aboriginal children with and without diarrhoea have greater
impairment in intestinal function than non-Aboriginal children, as
assessed by increased permeability ratios.
METHODSA descriptive
study of 124 children (96 Aboriginal and 28 non-Aboriginal)
hospitalised with and without diarrhoea. Intestinal permeability was
assessed by the lactulose to rhamnose (L-R) ratio from a five hour
urine collection.
RESULTSIn Aboriginal
children, mean L-R ratios (95% confidence intervals) were 18.3 (17.1 to 19.6) with diarrhoea and 9.0 (7.3 to 11.0) without diarrhoea, and in
non-Aboriginal children they were 5.9 (2.8 to 12.3) and 4.2 (3.3 to
5.2), respectively. In patients with diarrhoea, L-R ratios were
significantly raised when accompanied by acidosis (mean, 22.8; 95% CI,
17.0 to 30.5), hypokalaemia (mean, 20.7; 95% CI, 15.4 to 27.9), and
5% dehydration (mean, 24.3; 95% CI, 19.0 to 29.6) compared with
none of these complications (mean, 7.0; 95% CI, 3.5 to 13.8).
CONCLUSIONThe high
incidence of acidosis, hypokalaemia, and dehydration in Aboriginal
children admitted with diarrhoeal disease is related to underlying
small intestinal mucosal damage.
Keywords: intestinal absorption; diarrhoea; Aboriginal children
© 1999 by Archives of Disease in Childhood
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