Abstract:IntroduçãoO FINAL DA DÉCADA de 1950, Margareth Shiner descreveu um método para a obtenção de fragmentos do intestino delgado para avaliação histológica. Pode-se dizer que esta descoberta da Medicina propiciou condições para o início de vários estudos que, após quase 25 anos, permitiram definir de maneira consistente a enteropatia ambiental. Esta condição clínica deve ser entendida como uma doença da sociedade, que acomete a saúde e a qualidade de vida de inúmeras pessoas, crianças e adultos que vivem em condiç… Show more
“…The association between environmental enteropathy and protein-energy malnutrition has been proven since its initial descriptions [1][2][3], but linkage of cause and effect is not easily established, since the diet of groups with environmental enteropathy is in general inadequate from both the qualitative and the quantitative point of view. The fact that no association between bacterial overgrowth and greater anthropometric deficit has not been shown (Table 3) in children living in the urban slum does not rule out the possibility of environmental enteropathy being an aggravating factor in their nutritional condition.…”
Section: Discussionmentioning
confidence: 99%
“…It may be reversed through a change in environment, in the sense of improved living conditions, especially in the context of quality and standard of food and environmental sanitation [1][2][3][4]. This clinical entity should be understood as a societal disease, which affects the health and quality of life of innumerable people, both children and adults, who live under inappropriate environmental conditions [1,2]. The recognition of environmental enteropathy began in the decade of the 1960s and was known at that time as tropical enteropathy [3,4].…”
The aim of this study was to evaluate the breath hydrogen test in the diagnosis of small intestine bacterial overgrowth associated with asymptomatic environmental enteropathy in children living in an urban slum. Fifty school-age children living in a slum and 50 children who attended a private health clinic in the same town were included in the study. Breath hydrogen test was carried out after the administration of lactulose or glucose on two different days. Bacterial overgrowth was diagnosed when the hydrogen concentration increased more than 20 ppm in a sample collected for up to 60 min. Production of hydrogen was greater after the ingestion of lactulose than after the ingestion of glucose. Bacterial overgrowth was noted in 37.5% of the children living in the slum and in 2.1% of the control group (P<0.001). The children living in the slum presented a higher proportion of bacterial overgrowth when lactulose was used in the breath hydrogen test.
“…The association between environmental enteropathy and protein-energy malnutrition has been proven since its initial descriptions [1][2][3], but linkage of cause and effect is not easily established, since the diet of groups with environmental enteropathy is in general inadequate from both the qualitative and the quantitative point of view. The fact that no association between bacterial overgrowth and greater anthropometric deficit has not been shown (Table 3) in children living in the urban slum does not rule out the possibility of environmental enteropathy being an aggravating factor in their nutritional condition.…”
Section: Discussionmentioning
confidence: 99%
“…It may be reversed through a change in environment, in the sense of improved living conditions, especially in the context of quality and standard of food and environmental sanitation [1][2][3][4]. This clinical entity should be understood as a societal disease, which affects the health and quality of life of innumerable people, both children and adults, who live under inappropriate environmental conditions [1,2]. The recognition of environmental enteropathy began in the decade of the 1960s and was known at that time as tropical enteropathy [3,4].…”
The aim of this study was to evaluate the breath hydrogen test in the diagnosis of small intestine bacterial overgrowth associated with asymptomatic environmental enteropathy in children living in an urban slum. Fifty school-age children living in a slum and 50 children who attended a private health clinic in the same town were included in the study. Breath hydrogen test was carried out after the administration of lactulose or glucose on two different days. Bacterial overgrowth was diagnosed when the hydrogen concentration increased more than 20 ppm in a sample collected for up to 60 min. Production of hydrogen was greater after the ingestion of lactulose than after the ingestion of glucose. Bacterial overgrowth was noted in 37.5% of the children living in the slum and in 2.1% of the control group (P<0.001). The children living in the slum presented a higher proportion of bacterial overgrowth when lactulose was used in the breath hydrogen test.
“…Samples of exhaled air were collected at 15, 30, 45, 60, 90, 120, 150 and 180 minute intervals after lactulose ingestion. 4,[13][14][15][16][17] The no rebreathing valve set up device designed by QuinTron Instrument Company Inc. (Menomonee Falls, Wisconsin, USA) was used to collect exhaled air samples. The device has a valve that allows air to pass in one direction only.…”
Section: Methodsmentioning
confidence: 99%
“…[6][7][8][9][10][11][12][13] SIBO is still associated with poverty and may favor nutrient malabsorption as part of environmental enteropathy. [14][15][16][17] Height impairment has been noted in children with SIBO living in underdeveloped countries when interpreting the concentrations of hydrogen (H 2 ) and methane (CH 4 ) in the lactulose breath test. 16 Previous studies using only H 2 to interpret the test results did not show a height deficit in children with asymptomatic SIBO.…”
Objective: To evaluate the association between small intestinal bacterial overgrowth (SIBO) and weight and height impairment in children and adolescents with gastroenterology diseases. Methods: Observational and retrospective study. All 162 patients aged less than 19 years old who underwent breath test in search of SIBO between 2011 and 2016 were studied. Breath test was collected after the intake of 10 grams of lactulose. The concentration of hydrogen and methane was measured for 180 minutes after the beginning of the test by 12i QuinTronMicroLyzer device. Results: SIBO was identified in 51 (31.5%) patients. There was no difference between the age of those with (mean=8.7y.o; 25th and 75th percentile: 4.6 and 11.3) and without (mean=7.9y.o 25th and 75th percentile: 4.8 and 12.2) SIBO (p=0.910). There was no association between gender and SIBO (male 26.3% vs. female 36.3%, p=1.00). A lower median of height-for-age Z score (mean=-1.32; 25th and 75th percentile: -2.12 and -0.08 vs. mean=-0.59; 25th and 75th percentile: -1.57 and 0.22; p=0.04) was demonstrated in children with SIBO when compared with children without it. There was no difference between the BMI-for-age Z score of patients with (mean=-0.48) and without SIBO (mean=-0.06) (p=0.106). The BMI of patients with SIBO (median=15.39) was lower than of those without it (median=16.06); however, the statistical analysis was not significant (p=0.052). The weight-for-age Z score was lower in patients with SIBO (mean=-0.96) than in those without SIBO (mean=-0.22) (p=0.02) Conclusions: Children and adolescents with SBIO associated with diseases of the gastrointestinal tract have lower weight and height values.
“…Hence, it is possible to suggest that the higher %DR associated with inulin in the malnourished group was due not only to the action of this fructooligosaccharide but also to a reduced capacity for DMH activation. Furthermore, protein-calorie malnutrition may be associated with intestinal villous atrophy as well as with an imbalance in the intestinal microbiota (Morais and Neto, 2003). This possibility would also induce a lower capacity for DMH activation in the intestine consequent to the reduced availability of β-glucuronidase, as this enzyme is produced by intestinal bacteria.…”
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