Sucrose Permeability: A Simple Non-Invasive Marker of Gastro-Duodenal Damage in Dyspepsia

  • Tapan Kumar Saha Kumar Saha Armed Forces Medical College, Department of Biochemistry, Pune–411040, Maharashtra, India.
  • Arabinda Mohan Bhattarai Armed Forces Medical College, Department of Biochemistry, Pune–411040, Maharashtra, India.
  • Manushree Sharma Armed Forces Medical College, Department of Biochemistry, Pune–411040, Maharashtra, India.
Keywords: gastro-duodenal mucosal damage, endoscopy, sucrose excretion test, non-invasive.

Abstract

Introduction: Diagnosis of gastro-duodenal mucosal damage usually requires endoscopy, an invasive procedure. An attempt has been made to assess the clinical validity of sucrose permeability test as a non-invasive marker of gastro-duodenal damage.

Methods: The test was carried out in 65 patients of dyspepsia evaluated by endoscopy and 21 healthy controls. On endoscopy, gastro-duodenal epithelial damage was assessed in all patients of dyspepsia and grouped as: group 1 (normal gastro-duodenal mucosa, n=18), group 2 (Gastric ulcer, n=15), group 3 (Duodenal ulcer, n=10), group 4 (Gastritis, n=12) and group 5 (Duodenitis, n=10).

Results: The mean urinary sucrose excretions (mg) in 5 hours after 100g oral load was found to be significantly higher in patients of gastric ulcers (183.6 ±169.7, p value < 0.001), duodenal ulcers (151.7± 79.2, p value <0.001), gastritis (115.6±59.2, p value <0.001) and duodenitis (105.2± 122.2, p value <0.05) as compared to controls (35.2±17.2). However, the mean sucrose excretion in patients of dyspepsia with normal endoscopic findings (42.5±14.8 mg) was almost similar to the control group (p value >0.05). A ROC curve analysis taking endoscopic findings as gold standard was undertaken to find the optimum cut-off to detect gastro-duodenal epithelial damage.

Conclusions: The cut-off value of 64.5 mg/5h for urinary sucrose excretion provided the best sensitivity and specificity in the diagnosis of both surgical (gastric and duodenal ulcer) and non-surgical (gastritis and duodenitis) gastro-duodenal mucosal damage. At this cutoff sucrose permeability test provided a sensitivity of 72 % and specificity of 92%. Similarly, a cut-off value of 66.5 mg/5h of urinary sucrose excretion provided the best sensitivity and specificity in the diagnosis of surgical gastro-duodenal mucosal damage with sensitivity of 72% and specificity of 97%. 

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Abstract
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Published
2015-08-03
How to Cite
Saha, T. K. S., Bhattarai, A., & Sharma, M. (2015). Sucrose Permeability: A Simple Non-Invasive Marker of Gastro-Duodenal Damage in Dyspepsia. Medical Journal of Shree Birendra Hospital, 13(2), 1-5. https://doi.org/10.3126/mjsbh.v13i2.13106
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Original Articles