Can fecal zonulin be used as a biomarker in the detection of leaky bowel syndrome in patients with intestinal metaplasia? A prospective cross-sectional study

Abstract: Aim: Intestinal metaplasia is the most common finding in routine endoscopic studies. The relationship between intestinal metaplasia and intestinal dysbiosis and leaking intestine is now a known fact. In this study, we tried to show the detection of this chain of events, which may cause many diseases, with zonulin in stool, which is a non-invasive method. Material and Method: Endoscopy was performed on 20 patients with dyspeptic complaints as of January 2022. All patients were tested for zonulin in the stool using the Stool Sample Application System (SAS) and Elisa method. Endoscopic findings of the patients (intestinal metaplasia, atrophic gastritis, helicobacter (Hp) status) and zonulin values in the stool were examined. This study was designed as a prospective cross-sectional study. Results: The median age of the patients was 48.35 (December: 33-73). In this study, 40% of the patients were female and 60% were male. Of the 20 patients who underwent endoscopy, 14 had intestinal metaplasia (70%), 11 had atrophic gastritis (55%) and 14 had helicobacter (Hp). In our results, while zonulin was high in stool in all patients with these conditions, only statistical significance was observed between intestinal metaplasia and zonulin elevation. Conclusion: Zonulin excretion has increased in fecal excretion in cases with intestinal metaplasia and may be an important marker in these cases.