Avaliação do tempo de trânsito orocecal e do teste de tolerância à glicose em pacientes chagasicos e não chagasicos com ou sem constipação intestinal
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2014-06-10
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Universidade Federal de Goiás
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Background : Most patients with chagasic megacolon presents constipation. However
in about one third of patients, despite the megacolon, bowel habits are normal.On the
other hand, Chagasic patients may show constipation without evidence of colonic
involvement.Thus, the determining factors of constipation in Chagas disease, are not
completely understood. The question then arises: if it's not the megacolon solely
responsible for constipation, what other factors are involved? In an attempt to answer
this question, we evaluated the possibility of involvement not only of the colon, but
also of the small intestine, very important organ in the absorption of nutrients and the
formation of fecal bolus. This study evaluated whether there is change on orocecal
transit and glucose absorption in the small intestine of Chagasic patients and non
Chagasic with or without constipation by orocecal transit time measurement and the
oral glucose tolerance test. Methods :Six groups of patients were studied: 1) – control
group-Without constipation without megacolon and negative for Chagas disease
serology; 2)-With constipation without megacolon and negative serology for Chagas
disease; 3)-With constipation without megacolon and positive serology for Chagas
disease; 4)-Without constipation without megacolon and positive serology for Chagas
disease, 5)-With constipation with megacolon and positive serology for Chagas
disease. 6)-Without constipationwith megacolon and positive serology for Chagas
disease. For measurement of the orocecal transit time was used the H2 expired test.
Results : It was observed a great extension of this time in the Group of patients with
chagasic megacolon and constipation, which was statistically significant (p=0,001)
when compared to all the other groups studied. It was observed that this time is
greater in constipated than not constipated (p=0,005). The oral glucose tolerance test
used in the evaluation of glycemic curve, showed that blood glucose levels were
lower in Chagas disease patients, with statistically significant difference in relation to
patients with Chagasic constipation and/or megacolon at 30 (p=0,003),60(p=0,005) e
90 minutes (p=0,001). It was interesting to note that patients with constipation and
megacolon, were the only ones among all groups, which showed statistically
significant difference at the same time both for the glucose tolerance test as to
orocecal transit time. In conclusion, Chagasic patients with constipation and
megacolon the orocecal transit time is delayed and during glucose tolerance test
present highest rates of blood glucose.These data can correspond to a dysfunction
of peristalsis and glucose absorption in the small intestine in patients with Chaga´s
disease presenting with megacolon and constipation.
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BAFUTTO, Mauro. Avaliação do tempo de trânsito orocecal e do teste de tolerância à glicose em pacientes chagasicos e não chagasicos com ou sem constipação intestinal. Orientador: Ênio Chaves de Oliveira. 2014. 75 f. Tese (Doutorado em Ciências da Saúde) - Faculdade de Medicina, Universidade Federal de Goiás, 2014.