{
  "abstract": "Background\n\nIrritable bowel syndrome (IBS) is a disorder of gut-brain interaction often accompanied by psychiatric and/or somatic comorbidities. Intestinal-barrier dysfunction has been implicated in IBS pathophysiology. However, the contribution of psychiatric and somatic comorbidities to intestinal permeability remains unclear. We aimed to assess intestinal permeability in a large multicentric cohort of IBS patients with and without psychiatric and/or somatic comorbidities, compared with disease controls, and healthy subjects.Methods\n\nIBS patients and disease controls were recruited across nine European centres. Small intestinal and colonic permeabilities were assessed using the lactulose-mannitol-sucralose urinary excretion test. Urinary sugar concentrations were quantified by gas chromatography-mass spectrometry. Analyses were adjusted for relevant clinical and lifestyle confounders.Results\n\nThe lactulose/mannitol (L/M) ratio, but not the percentage of sucralose (%S), was significantly increased in IBS patients (N = 418) compared with disease controls (N = 200), regardless of IBS subtype or sex. Notably, the increased L/M in IBS patients was primarly driven by a significant decrease in mannitol excretion. IBS patients with psychiatric or combined psychiatric and somatic comorbidities showed a higher L/M than their corresponding disease control groups. However, L/M values did not differ between IBS patients with and without comorbidities. Substantial between-centre variability in L/M ratios awas observed.Discussion\n\nSmall intestinal, but not colonic, permeability, as reflected by an elevated L/M ratio, is increased in IBS patients. These alterations seem to be related to the presence of IBS per se rather than to comorbid conditions. Interestingly, substantial geographic variability was observed, which may reflect environmental or population-related factors influencing barrier function. Further investigations are needed to better understand the clinical relevance of these findings.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Chronic Diseases and Metabolism (CHROMETA), Translational Research Centre for Gastrointestinal Disorders (TARGID), KU Leuven, Leuven, Belgium.",
    "Laboratory of Neuro-Immuno-Gastroenterology, Digestive System Research Unit, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.",
    "Department of Gastroenterology, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.",
    "Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III, Madrid, Spain.",
    "Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain.",
    "Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.",
    "Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain.",
    "Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.",
    "Mental Health Department, Treatment-Resistant Depression Programme, The Brain-Inmune-Gut Unit, Vall d'Hebron Hospital Campus, Barcelona, Spain.",
    "Centro de Investigación Biomédica en Red, Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.",
    "Division of Rheumatology Research, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain.",
    "Division of Rheumatology, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain.",
    "Department of Gastroenterology-Hepatology, NUTRIM Institute of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, the Netherlands.",
    "Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.",
    "IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.",
    "Università di Bologna, Bologna, Italy.",
    "Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.",
    "Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt-Goethe University, Frankfurt, Germany.",
    "Departments of Psychiatry and Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands.",
    "Universitatea De Medicina Si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania.",
    "Department of Chronic Diseases and Metabolism (CHROMETA), Epithelial Physiology and Organ Interaction (EPIC) Lab, Translational Research Centre for Gastrointestinal Disorders (TARGID), KU Leuven, Leuven, Belgium."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 34,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Alice Rustichelli",
      "orcid": "0000-0002-1214-3979"
    },
    {
      "affs": [
        1
      ],
      "name": "Juan Manuel Garcia-Illarramendi",
      "orcid": "0000-0003-3368-814X"
    },
    {
      "affs": [
        1,
        2,
        3,
        4
      ],
      "name": "Javier Santos",
      "orcid": "0000-0002-4798-5033"
    },
    {
      "affs": [
        1,
        2,
        3
      ],
      "name": "Ana Maria González-Castro",
      "orcid": "0000-0003-3955-3318"
    },
    {
      "affs": [
        5
      ],
      "name": "Magnus Simrén",
      "orcid": "0000-0002-1155-1313"
    },
    {
      "affs": [
        5
      ],
      "name": "Irina Midenfjord",
      "orcid": "0000-0003-3168-1075"
    },
    {
      "affs": [
        6,
        7,
        8,
        9
      ],
      "name": "Amanda Rodriguez-Urrutia",
      "orcid": "0000-0001-6882-205X"
    },
    {
      "affs": [
        1,
        2,
        3
      ],
      "name": "Elba Expósito",
      "orcid": "0000-0001-6088-3149"
    },
    {
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        1,
        2,
        3,
        4
      ],
      "name": "Beatriz Lobo",
      "orcid": "0000-0003-3391-7125"
    },
    {
      "affs": [
        10,
        11
      ],
      "name": "Jose Alegre-Martin",
      "orcid": "0000-0002-7582-7585"
    },
    {
      "affs": [
        10,
        11
      ],
      "name": "Miriam Almirall",
      "orcid": "0000-0002-4874-8013"
    },
    {
      "affs": [
        10
      ],
      "name": "Jesús Castro-Marrero",
      "orcid": "0000-0002-2481-3052"
    },
    {
      "affs": [
        10,
        11
      ],
      "name": "Ramon Sanmartin-Sentañes",
      "orcid": "0000-0002-6415-6368"
    },
    {
      "affs": [
        0
      ],
      "name": "Jan Tack",
      "orcid": "0000-0002-3206-6704"
    },
    {
      "affs": [
        0
      ],
      "name": "Florencia Carbone",
      "orcid": "0000-0003-1790-7904"
    },
    {
      "affs": [
        0
      ],
      "name": "Lukas Van Oudenhove",
      "orcid": "0000-0002-6540-3113"
    },
    {
      "affs": [
        0
      ],
      "name": "Maaike Van Den Houte",
      "orcid": "0000-0002-9432-0333"
    },
    {
      "affs": [
        0
      ],
      "name": "Liene Bervoets",
      "orcid": "0000-0001-6600-2584"
    },
    {
      "affs": [
        0
      ],
      "name": "Sybren Rinckhout",
      "orcid": "0009-0007-0362-3026"
    },
    {
      "affs": [
        12
      ],
      "name": "Daisy Jonkers"
    },
    {
      "affs": [
        12
      ],
      "name": "Michelle Bosman",
      "orcid": "0000-0002-2040-2520"
    },
    {
      "affs": [
        13,
        14,
        15
      ],
      "name": "Maria Raffaella Barbaro",
      "orcid": "0000-0003-4438-554X"
    },
    {
      "affs": [
        13,
        14,
        15
      ],
      "name": "Giovanni Barbara",
      "orcid": "0000-0001-9745-0726"
    },
    {
      "affs": [
        16
      ],
      "name": "Istvan Bitter",
      "orcid": "0000-0002-9464-4709"
    },
    {
      "affs": [
        16
      ],
      "name": "Eva Jekkel",
      "orcid": "0000-0003-2184-6972"
    },
    {
      "affs": [
        17
      ],
      "name": "Andreas Reif",
      "orcid": "0000-0002-0992-634X"
    },
    {
      "affs": [
        17
      ],
      "name": "Mareike Aichholzer",
      "orcid": "0000-0002-1291-3304"
    },
    {
      "affs": [
        17
      ],
      "name": "Carmen Uckermark",
      "orcid": "0009-0005-8295-6835"
    },
    {
      "affs": [
        18
      ],
      "name": "Alejandro Arias Vasquez",
      "orcid": "0000-0002-4786-0169"
    },
    {
      "affs": [
        19
      ],
      "name": "Dan Lucian Dumitrascu",
      "orcid": "0000-0001-5404-7662"
    },
    {
      "affs": [
        19
      ],
      "name": "Andrei-Vasile Pop",
      "orcid": "0009-0003-8579-0821"
    },
    {
      "affs": [
        0
      ],
      "name": "Kristin Verbeke",
      "orcid": "0000-0002-5352-7565"
    },
    {
      "affs": [
        1,
        2,
        3,
        4
      ],
      "name": "Carmen Alonso-Cotoner",
      "orcid": "0000-0002-3483-2919"
    },
    {
      "affs": [
        0,
        20
      ],
      "name": "Ricard Farré",
      "orcid": "0000-0001-7158-171X"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/933znqt0z5hdw.bib",
  "cited_by": 0,
  "doi": "10.1002/ueg2.70301",
  "fulltext_url": "https://europepmc.org/articles/PMC13728547",
  "id": "933znqt0z5hdw",
  "issns": [
    "2050-6406",
    "2050-6414"
  ],
  "landing_url": "https://europepmc.org/article/MED/42973115",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Neurogastroenterology"
    ],
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2715|Gastrointestinal motility and disorders"
    ]
  ],
  "openalex": "W7225136741",
  "pdf_url": "https://europepmc.org/articles/PMC13728547?pdf=render",
  "pmcid": "PMC13728547",
  "pmid": "42973115",
  "published": "2026-11-01",
  "publisher": "Wiley",
  "ris": "https://research.draconitic.com/paper/933znqt0z5hdw.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T15:20:47Z",
      "native_id": "MED:42973115",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42973115"
    },
    {
      "first_seen": "2026-11-07T12:21:30Z",
      "native_id": "PMC13728547",
      "source": "pmc",
      "url": "https://doi.org/10.1002/ueg2.70301"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2715|Gastrointestinal motility and disorders",
      "subfield": "general"
    }
  ],
  "title": "Intestinal Permeability in Irritable Bowel Syndrome With and Without Comorbid Conditions: Results From the European DISCOvERIE Cohort.",
  "title_text": "Intestinal Permeability in Irritable Bowel Syndrome With and Without Comorbid Conditions: Results From the European DISCOvERIE Cohort.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:21:30Z",
  "url": "https://research.draconitic.com/paper/933znqt0z5hdw",
  "venue": "United European gastroenterology journal",
  "versions": []
}