Vindaloo and you

Correspondence and reprints to: Dr Bjarnason. Recent developments have led to the introduction of various test substances to assess intestinal permeability, some of which test the barrier function of the small intestinal mucosa.M Most of the tests are simple, comprising ingestion of a solution containing a poorly metabolised test substance and subsequent collection of urine over 5-24 hours for analysis of the test markers. Such tests have shown abnormal intestinal permeability in several gastrointestinal conditions,1"1 and because of their non-invasive nature they can be applied to diagnostic ^screening and research.57 Furthermore, close attention to apparent anomalies of intestinal permeability has led to the description of a new enteropathy caused by non-steroidal anti inflammatory drugs that is not evident using conven? tional techniques.810 Permeability tests have not, however, been met with universal success as diagnostic screening tests. In particular, the indigenous "normal" populations of east and west Africa,11 u the Middle East,13 Indonesia, Papua New Guinea, India, and Thailand (I S Menzies, unpublished observations) have such high perme? ability values that the tests do not discriminate between subjects with disease and normal subjects. This is in sharp contrast with the low normal values and sensitivity of the tests in whites in England,M the Continent,1419 America,2022 and Australia.23 The reasons for these differences are unknown, but as ethnic Asian (from India or Pakistan) residents in the United Kingdom24 and white residents in tropical countries mentioned (I S Menzies, unpublished obser? vations) have pronounced intestinal hyperpermeability it has been suggested that dietary factors may be important in disrupting intestinal integrity. We assessed whether ingesting three Indian meals on consecutive evenings altered intestinal function by a combined absorption and permeability test.