BACKGROUND: Irritable bowel syndrome is a clinical condition presenting pain, distension and abdominal fullness, diarrhea, constipation, and other symptoms. It generates significant impacts on the quality of life of those affected. The pathophysiology is uncertain, but the role of various food types has been established in bowel sensitivity and its clinical manifestations. Carbohydrate intolerance, particularly to lactose, generates similar and sometimes indistinguishable symptoms from irritable bowel syndrome, and in clinical practice is both a frequent and underdiagnosed condition. Carbohydrate intolerance is related to enzymatic deficiencies, alterations of intestinal microbiota and even genetic change. The principal test for a diagnosis of lactose intolerance is the breath test, which measures hydrogen emission (produced only by bacteria), after ingestion of the corresponding substrate. OBJECTIVE: The present work aims to verify the prevalence of lactose intolerance in university students, presenting gastrointestinal symptoms suggestive of irritable bowel syndrome. METHODS: In a transversal study, to screen for those with suggestive symptoms, 124 medicine students participated by responding to a form. Those with abdominal pain were referred for anti-parasite treatment in order to exclude intestinal parasites as a secondary cause. Subsequently, using the hydrogen breath test, bacterial overgrowth was investigated, and if negative, lactose intolerance testing would be performed. Patients presenting high hydrogen concentrations of ≥20 ppm above the basal level were considered lactose intolerant. RESULTS: Of the total of students researched (n=124), 7 were excluded because they did not completing all study phases. From those 117 individuals effectively included in the survey; 8 (6.8%) were diagnosed with lactose intolerance and 2 (1.7%) with bacterial overgrowth. Intolerance was more frequent in; female individuals (75%), age range 18 to 25 years (62.5%), being colored (50%), and in their 5th semester of studies (37.5%). The presence of at least one gastrointestinal symptom among those presenting intolerance (100%), and those not presenting intolerance (42.2%) was found (P=0.002). In addition to abdominal pain (100%) (P<0.001), the most recurrent gastrointestinal symptom in the lactose intolerant students was the distension/flatulence (62.5%) (P=0.026). In relation to life habits and food patterns, there was no statistical difference between lactose tolerant and intolerant individuals, or for symptom frequencies. The more advanced students, completing more periods towards graduation, demonstrated more occurrences of gastrointestinal symptoms, yet without presenting significant statistical discrepancies. CONCLUSION: In view of the test sample quantity (n=21), a high prevalence of lactose intolerance (6.8%) in the academic environment, with epidemiological characteristics compatible to those found the literature is demonstrated, generating knowledge with understanding to prevent, diagnose, alleviate and treat lactose intolerant university students, and generate positive impacts towards well-being, improving the quality of life of these individuals.
In regions where sanitary conditions are poor, prophylactic administration of antiparasitic drugs is common and affects the prevalence of intestinal parasites, in spite of the environmental maintenance of their life cycle. The purpose of this study was to evaluate the prevalence of parasitic infections, patient lifestyles, health conditions and environmental sources of contamination. One hundred seventy two children and adolescents, 5 to 15 years of age of both sexes were analyzed. Data were obtained through epidemiological questionnaires, parasitological examinations using Paratest®, IgG testing for Entamoeba histolytica, and analysis of sources of contamination in living areas. The study detected a prevalence of 45.9% (79/172) parasitic infections, of which 62.0% (49/79) Entamoeba histolytica/E. dispar complex; 46.8% (37/79) Entamoeba coli; 27.8% (22/79) Giardia intestinalis; 12.7% (10/79) Endolimax nana; 10.1% (8/79) Hymenolepis nana; 8.9% (7/79) Ascaris lumbricoides and 2.5% (2/79) Trichuris trichiura. Out of the 49 samples positive for Entamoeba histolytica complex, there was only one case of antibodies to E. histolytica. The children’s life habits demonstrated inadequate food hygiene practices. These insufficient sanitary parameters revealed a general lack of information in face of an alarming situation regarding sewage and other sources of environmental contamination in 20% of the areas. The high prevalence of protozoan infections despite chemoprophylaxis, with environmental sources of contamination/risk, inadequate health conditions and the general apathy of the population suggest the ineffectiveness of current preventive practices. Thus, it is advisable that control actions include protozoa as therapeutic targets and, above all, health education as a routine practice to prevent the long-term continuance of this vicious cycle. KEY WORDS: Parasitic infections; chemoprophylaxis; environmental sources.
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