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Estudo da motilidade gastrointestinal e da função autonomica em pacientes com dispepsia funcional : influencia do genero e de fatores psicologicos

Orientador: Maria Aparecida Mesquita / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-04T04:20:07Z (GMT). No. of bitstreams: 1
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Previous issue date: 2005 / Resumo: os objetivos deste estudo foram investigar, em um grupo de pacientes com dispepsia funcional do tipo dismotilidade, o esvaziamento e a distribuição intragástrica de uma dieta sólida, o trânsito intestinal pela determinação do tempo de trânsito orocecal, e a função autonômica simpática e parassimpática, avaliando ainda a influência do gênero nestes parâmetros. Além disso, foi investigada uma possível correlação entre as anormalidades motoras encontradas nestes pacientes com a presença de alterações da função do sistema nervoso autonômico, com os distúrbios do humor, e com a infecção pela bactéria Helicobacter pylori. Foram estudados vinte e três pacientes com dispepsia funcional (17 do sexo feminino) que tinham com sintoma predominante a plenitude gástrica pós-prandial. O estudo do esvaziamento gástrico e da distribuição intragástrica da dieta sólida padronizada foi realizado pela cintilografia, e o estudo do tempo de trânsito orocecal foi realizado pelo teste do 'H IND. 2¿ no ar expirado, após ingestão de lactulose. A função autonômica foi avaliada através de testes de reflexos cardiovasculares padronizados e da análise da variabilidade da freqüência cardíaca em 24 horas. A pesquisa da infecção da mucosa gástrica pelo Helicobacter pylori foi realizada através do exame histológico, do teste da uréase e do teste respiratório com uréia marcada com 'C ANTPOT. 14¿... Observação: O resumo, na íntegra, poderá ser visualizado no texto completo da tese digital / Abstract: The aims of this study were to investigate the gastric emptying and intragastric distribution of a solid meal, the orocecal transit time, and the function of the autonomic nervous system in patients with dysmotility like functional dyspepsia, and the influence of gender on these parameters. In addition, a possible association between the motor abnormalities observed in these patients with the presence of autonomic dysfunction, humor alterations and H. pylori infection was also assessed. Twenty-three patients with functional dyspepsia (female sex: 17) all complaining of epigastric fullness were studied. Total and compartmental gastric emptynig of a solid meal were assessed by gastric emptying scintigraphy. Orocecal transit time was measured by the lactulose hydrogen breath test. The sympathetic and parasympathetic autonomic function was assessed by analysis of 24-hr heart rate variability and a baterry of standardized cardiovascular reflex tests. The presence of H. pylori in dyspeptic patients was assessed by histological examination, the urease test, and the C urea breath test. The presence of anxiety and depression was assessed by the Hospital Anxiety and Depression (HAD) scale. Delayed gastric emptying was related to female sex, while the abnormalities of intragastric meal distribution were observed in both men and women with functional dyspepsia. There was no evidence of gender influence in both orocecal transit time and autonomic function. Seventeen (73%) patients had anxiety evaluated by the HAD scale. Anxiety was significantly correlated to greater meal retention in the gastric compartment in dyspeptic patients (p=0.04). In conclusion, our results showed that delayed gastric emptying occurs only in a subgroup of functional dyspepsia patients, even among those characterized by the predominant sympton of epigastric fullness, indicating that other factors, such as the abnormalities of intragastric meal distribution, play an important role in the production of dysmotility symptoms. Our study showed that prolonged gastric emptying in patients with functional dyspepsia is related to the female sex, while the abnormalities of the meal intragastric distribution appear to occur in dyspepetic males and females. Anxiety is frequent in functional dyspepsia and seems to be related to abnormal antral retention of food in these patients. Despite our findings of impaired efferent vagal function in a subgroup of dyspeptic patients, the analysis of our data did not reach statistical significance to confirm the hypothesis that the autonomic dysfunction is the mediating factor between anxiety and the observed gastric motor abnormalities in these patients / Doutorado / Clinica Medica / Doutor em Clínica Médica

Identiferoai:union.ndltd.org:IBICT/oai:repositorio.unicamp.br:REPOSIP/310803
Date25 February 2005
CreatorsLorena, Sonia Leticia Silva
ContributorsUNIVERSIDADE ESTADUAL DE CAMPINAS, Mesquita, Maria Aparecida, 1956-, Troncon, Luiz Ernesto de Almeida, Zaterka, Schlioma, Magalhães, Antonio Frederico Novaes de, Zeitune, José Murilo Robilotta
Publisher[s.n.], Universidade Estadual de Campinas. Faculdade de Ciências Médicas, Programa de Pós-Graduação em Clínica Médica
Source SetsIBICT Brazilian ETDs
LanguagePortuguese
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis
Format129p. : il., application/pdf
Sourcereponame:Repositório Institucional da Unicamp, instname:Universidade Estadual de Campinas, instacron:UNICAMP
Rightsinfo:eu-repo/semantics/openAccess

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