RESUMO
BACKGROUND: Bariatric surgery is considered the only effective method to treat refractory obesity, and especially for those in which clinical treatment was not successful. However, the appearance of food intolerances and clinical manifestations are quite common. AIM: To identify food intolerances and associated them to symptoms in patients undergoing Fobi-Capella technique without gastric ring. METHODS: This was a cross-sectional study of adult patients who had more than one year after surgery. Demographic, anthropometric, weight and preoperative height data were investigated. Nutritional status was classified according to the criteria established by the World Health Organization. It was considered food intolerance the presence of nausea, vomiting, diarrhea or bloating after eating a particular food. RESULTS: The sample consisted of 61 patients who attended the nutritional consultation of which 26 (42.6%) had food intolerance, mostly related to red meat (n=12; 34.3%) during the first six months of operation; there was a significant difference between the periods between 0 and 6 months, and 7 to 12 (p=0.02). Among the symptoms reported by patients, nausea was the most recurrent until the 6th month, but without significant differences between the two periods (p=0.06). CONCLUSION: The Fobi-Capella procedure without gastric ring promoted high frequency of intolerance to meat in general, especially for the red, chicken and fish, on this sequence; nausea was the most frequent symptom. These data suggest the need for adequate nutritional monitoring throughout the postoperative period.
Assuntos
Hipersensibilidade Alimentar/diagnóstico , Hipersensibilidade Alimentar/etiologia , Derivação Gástrica/efeitos adversos , Adulto , Estudos Transversais , Feminino , Derivação Gástrica/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
BACKGROUND: Bariatric surgery is considered the only effective method to treat refractory obesity, and especially for those in which clinical treatment was not successful. However, the appearance of food intolerances and clinical manifestations are quite common. AIM: To identify food intolerances and associated them to symptoms in patients undergoing Fobi-Capella technique without gastric ring. METHODS: This was a cross-sectional study of adult patients who had more than one year after surgery. Demographic, anthropometric, weight and preoperative height data were investigated. Nutritional status was classified according to the criteria established by the World Health Organization. It was considered food intolerance the presence of nausea, vomiting, diarrhea or bloating after eating a particular food. RESULTS: The sample consisted of 61 patients who attended the nutritional consultation of which 26 (42.6%) had food intolerance, mostly related to red meat (n=12; 34.3%) during the first six months of operation; there was a significant difference between the periods between 0 and 6 months, and 7 to 12 (p=0.02). Among the symptoms reported by patients, nausea was the most recurrent until the 6th month, but without significant differences between the two periods (p=0.06). CONCLUSION: The Fobi-Capella procedure without gastric ring promoted high frequency of intolerance to meat in general, especially for the red, chicken and fish, on this sequence; nausea was the most frequent symptom. These data suggest the need for adequate nutritional monitoring throughout the postoperative period. .
RACIONAL: A cirurgia bariátrica é considerada o único método efetivo para tratamento da obesidade refratária e, principalmente, para aqueles em que o tratamento clínico não obteve sucesso. No entanto, o surgimento de intolerâncias alimentares e manifestações clínicas após são bastante comuns. OBJETIVO: Identificar intolerâncias alimentares e sintomas associados em pacientes submetidos à técnica de Fobi-Capella sem anel gástrico. MÉTODOS: Trata-se de um estudo transversal com pacientes adultos que possuíam no máximo um ano de pós-operatório. Foram investigados dados demográficos, antropométricos, peso e estatura pré-cirúrgicos. O estado nutricional foi classificado de acordo com os critérios estabelecidos pela World Health Organization. Considerou-se intolerância alimentar a presença de náuseas, vômitos, diarreia ou distensão abdominal após ingestão de um alimento específico. RESULTADOS: A amostra foi composta por 61 pacientes que compareceram a consulta nutricional dos quais 26 (42,6%) apresentaram intolerância alimentar, sendo a maioria relacionada à carne vermelha (n=12; 34,3%) durante os primeiros seis meses da operação, havendo redução significativa entre os períodos de 0 a 6 meses e 7 a 12 meses (p=0,02). Dentre os sintomas relatados pelos pacientes, a náusea foi o mais recorrente até o 6º mês, porém sem diferença estatística entre os dois períodos (p=0,06). CONCLUSÃO: O procedimento de Fobi-Capella sem anel gástrico promoveu elevada frequência de intolerância às carnes em geral, principalmente para a vermelha, frango e peixe, nesta sequência; a náusea foi o sintoma mais frequente. Estes dados sugerem necessidade de acompanhamento nutricional adequado durante todo o período pós-operatório. .
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , /sangue , /diagnóstico , Proteína Antagonista do Receptor de Interleucina 1/sangue , Estudos de Casos e Controles , Fatores de RiscoRESUMO
Bariatric surgery (BS) is considered the only effective method to treat refractory obesity. This study evaluated the clinical-nutritional behavior of obese patients submitted to Roux-en-Y gastric bypass. This cross-sectional and analytical study evaluated weight, Body Mass Index (BMI), weight loss percentage (% WLP), excess weight loss (%EWL) and clinical manifestations. Results were evaluated considering a significance level of 5%. The sample was composed of 37 obese patients, mainly females (n = 26), median age of 40 years. Progressive and significant reduction of weight (128.2 +/- 21.5 vs. 104.4 +/- 18.2 kg), BMI (49.3 +/- 7.7 vs. 40.4 +/- 6.8 kg/m2) and consequent increase in the %WLP (18.6 +/- 3.9%) and %EWL (39.4 +/- 10.6%) were observed over 90 days of follow-up (P < 0.001). Significant increase in the number of patients presenting alopecia (10 vs. 18) and diminished events of dumping syndrome (9 vs 8) and xerostomia (21 vs. 11) were evidenced between 30 and 90 postoperative days. There was also significant reduction in the levels of fasting glucose (100.9 +/- 32.0 vs 83.0 +/- 12.3 mg/dL), total cholesterol (208.1 +/- 38.5 vs. 173.3 +/- 48.2 mg/dL), triglycerides (150.9 +/- 7.7 vs. 102.2 +/- 27.3 mg/dL), hemoglobin (13.3 +/- 1.4 vs. 12.6 +/- 1.0 g/dL) and hematocrit (41.1 +/- 3.8 vs. 39.2 +/- 3.3%) at 90 postoperative day compared to the preoperative period (P < 0.005). We conclude that BS is an effective treatment for weight loss and improved lipid and glycemic profiles. However, the frequency of alopecia and significant reduction in the hemoglobin and hematocrit levels at 90 posotperative day deserves attention.