Avaliação da frequência de má digestão e de intolerância à lactose em pacientes com doença inflamatória intestinal
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Data
2022-12-15
Autores
Araújo, Vanessa de Castro Gomes [UNIFESP]
Orientadores
Ambrogini Júnior, Orlando [UNIFESP]
Tipo
Dissertação de mestrado
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Objetivo: Identificar a frequência de má digestão e de intolerância à lactose (IL) em pessoas com doença inflamatória intestinal (DII), classificar o estado nutricional e verificar se houve restrição de lácteos após o diagnóstico. Métodos: Estudo de corte transversal, com 42 participantes acompanhados no ambulatório de Doenças Inflamatórias Intestinais da Disciplina de Gastroenterologia, da Escola Paulista de Medicina, da UNIFESP de setembro de 2016 a setembro de 2018. Após a concondância e assinatura do Termo de Consentimento Livre e Esclarecido, os participantes foram questionados sobre seus dados pessoais, clínicos e alimentares. Fez-se a aferição de peso e estatura, coleta de exames de calprotectina fecal e proteína C reativa, e posterior teste de hidrogênio expirado (THE). Resultados: Foram incluídos 42 participantes, 22 com diagnóstico de retocolite ulcerativa (52,4%) e 20 com doença de crohn (47,6%). Houve predomínio do gênero feminino (59,5%), idade média de 40 anos de idade e Índice de Massa Corporal (IMC) na eutrofia, metade se declararam brancos. Os índices de inflamação foram avaliados por calprotectina fecal com (62,1%) dos resultados positivos, PCR maior que 1,0mg/dL em (75%) dos participantess. Diagnóstico de má digestão ocorreu em 16 (38,1%) indivíduos e dentre estes, 5 (11,9%) com diagnóstico de IL. Dos 42 participantes, 32 (76,2%) relataram restrição de lácteos. Conclusão: Foi visto que 16 (38,1%) participantes tiveram alteração no THE, e destes, 5 (11,9%) relataram sintomas em até 12 horas após o THE, classificando intolerância à lactose. No grupo estudado, 32 dos 42 participantes (76,2%) relataram modificação no consumo de lácteos após o diagnóstico, o grupo avaliado estava com peso adequado (eutrófico) ou com sobrepeso no momento da avaliação e com os marcadores inflamatórios alterados (calprotectina e PCR). A restrição à lacteos possivelmente desnesserária foi de (76,2%). Sugere-se o uso do THE para avaliar se há alteração na digestão da lactose ou sintomas após a ingestão da mesma. Sendo o consumo de lácteos ajustado de acordo com a remissão da doença e estratégias nutricionas para tolerância desse tipo de açúcar.
Objective: To identify the frequency of maldigestion and lactose intolerance (IL) in patients with inflammatory bowel disease (IBD), classify the nutritional status and verify if there was dairy restriction after diagnosis. Methods: Cross-sectional study, with 42 participants followed up at the Inflammatory Bowel Diseases outpatient clinic of the Discipline of Gastroenterology, Escola Paulista de Medicina, UNIFESP from September 2016 to September 2018. After consent and signing of the Free and Clarified, patients were asked about their personal, clinical and dietary data. Weight and height were measured, fecal calprotectin and C-Reactive Protein exams were collected, and later the Expired Hydrogen Test (THE). Results: 42 participants were included, 22 diagnosed with ulcerative colitis (52.4%) and 20 with Crohn's disease (47.6%). Predominance of females (59.5%), mean age of 40 years and Body Mass Index (BMI) in eutrophic, half declared themselves white. Inflammation indices were assessed by fecal calprotectin with (62.1%) positive results, CRP greater than 1.0mg/dL in (75%) of the participants. Diagnosis of maligestion occurred in 16 (38.1%) individuals and among these, 5 (11.9%) were diagnosed with Lactose Intolerance. Of the 42 participants, 32 (76.2%) reported dairy restriction. Conclusion: It was seen that 16 (38.1%) participants had alterations in THE, and of these, 5 (11.9%) reported symptoms within 12 hours after THE, classifying IL. In the studied group, 32 of the 42 (76.2%) reported a change in dairy consumption after diagnosis, the evaluated group was with adequate weight (eutrophic) or overweight at the time of evaluation and with altered inflammatory markers (calprotectin and CRP). Restriction to possibly desnesserary dairy products was (76.2%). The use of THE is suggested to assess whether there is a change in lactose digestion or symptoms after ingestion. Dairy consumption was adjusted according to disease remission and nutritional strategies for sugar tolerance.
Objective: To identify the frequency of maldigestion and lactose intolerance (IL) in patients with inflammatory bowel disease (IBD), classify the nutritional status and verify if there was dairy restriction after diagnosis. Methods: Cross-sectional study, with 42 participants followed up at the Inflammatory Bowel Diseases outpatient clinic of the Discipline of Gastroenterology, Escola Paulista de Medicina, UNIFESP from September 2016 to September 2018. After consent and signing of the Free and Clarified, patients were asked about their personal, clinical and dietary data. Weight and height were measured, fecal calprotectin and C-Reactive Protein exams were collected, and later the Expired Hydrogen Test (THE). Results: 42 participants were included, 22 diagnosed with ulcerative colitis (52.4%) and 20 with Crohn's disease (47.6%). Predominance of females (59.5%), mean age of 40 years and Body Mass Index (BMI) in eutrophic, half declared themselves white. Inflammation indices were assessed by fecal calprotectin with (62.1%) positive results, CRP greater than 1.0mg/dL in (75%) of the participants. Diagnosis of maligestion occurred in 16 (38.1%) individuals and among these, 5 (11.9%) were diagnosed with Lactose Intolerance. Of the 42 participants, 32 (76.2%) reported dairy restriction. Conclusion: It was seen that 16 (38.1%) participants had alterations in THE, and of these, 5 (11.9%) reported symptoms within 12 hours after THE, classifying IL. In the studied group, 32 of the 42 (76.2%) reported a change in dairy consumption after diagnosis, the evaluated group was with adequate weight (eutrophic) or overweight at the time of evaluation and with altered inflammatory markers (calprotectin and CRP). Restriction to possibly desnesserary dairy products was (76.2%). The use of THE is suggested to assess whether there is a change in lactose digestion or symptoms after ingestion. Dairy consumption was adjusted according to disease remission and nutritional strategies for sugar tolerance.
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Citação
ARAÚJO, Vanessa de Castro Gomes. Avaliação da frequência de má digestão e de intolerância à lactose em pacientes com doença inflamatória intestinal. 2022. Dissertação (Mestrado em Gastroenterologia) - Escola Paulista de Medicina, Universidade Federal de São Paulo, 2022.