Intestinal permeability (IP) studies using some macromolecules have been assumed to demonstrate the intactness or intestinal mucosa. The aim of the present study is to determine the changes in IP among patients with protozoan infections. Thirty nine patients with protozoan infections and ten healthy controls were enrolled in the study. Protozoa were diagnosed by Native-lugol, Richie and Trichrome staining of faeces. IP was evaluated by diethyl triamine penta acetic acid labeled with 99m Technetium (Tc-99m labeled DTPA) assay. The IP was found to have increased in patients with protozoan infections compared with control patients (7.20 +/- 5.52 vs. 4.47 +/- 0.65%, P = 0.0017). The IP values were 9.91 +/- 10.05% in Giardia intestinalis group, 6.81 +/- 2.25% in Blastocystis hominis group, 5.78 +/- 2.84% in Entamoeba coli group. In comparison with the control group, the IP was significantly higher in G. intestinalis and B. hominis patients (P = 0.0025, P = 0.00037, respectively), but not in E. coli patients. In conclusion, the IP increases in patients with G. intestinalis and B. hominis but not with E. coli infection. This finding supports the view that IP increases during the course of protozoan infections which cause damage to the intestinal wall while non-pathogenic protozoan infections have no effect on IP. The increase in IP in patients with B. hominis brings forth the idea that B. hominis can be a pathogenic protozoan. (C) 2002 Elsevier Science B.V. All rights reserved.