Assessment of clinical and nutritional parameters with the use of probiotics Lactobacillus casei and Bifidobacterium breve in Crohn s disease / Avaliação de parametros clinicos e nutricionais com emprego dos probioticos Lactobacillus casei e Bifidobacterium breve portadores de Doença de Crohn

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

Patients with Crohn s disease (CD) frequently present diarrhea and malnutrition, which is hard to treat and influenced by the disease activity, location and extension of intestinal involvement. The application of probiotics on intestinal inflammatory diseases can be useful because of its effects on intestinal microbiota, with potential anti-inflammatory and immunologic actions. The goal of this study is to assess the effectiveness of the usage of probiotics Lactobacillus casei and Bifidobacterium breve (PROLB) in CD carriers with relation to the evacuation frequency, degree of disease activity, and nutrition parameters variation. Between March 2007 and October 2008, fifteen patients caring CD disease were assessed with liquid evacuation frequency greater than or equal to three times a day. The average age was 43.83 (21-56 years), predominantly females (66,67%). All the participant patients used the PROLB orally for three months, daily ingesting the product Yakult LB Intestinal Regulator (Yakult Honsha Co., Ltd, Tokyo - Japan), which contains in each envelop a gram, two probiotic strains: Lactobaccillus casei (2 x 107 a 109 UFC) and Bifidobacterium breve (5 x 107 a 109 UFC). In order to asses the degree of the disease the clinic index Harvey-Bradshaw (H-B) and erythrocyte sedimentation rate (ESR) and C reative protein (CRP) sampling. The evacuation frequencies were obtained by forms fulfilled by the patients and also during the first and last appointment. The assessment of the nutritional state was performed by albumin seric sampling and through the following anthropometric measures: weight, body mass index (BMI), triceps skinfold thickness (TST), arm circumference (AC), and derived measurements. The Frisancho (1981, 1990) criteria were used to classify the nutritional status. The application of PROLB evidenced (i) the reduction of the disease activity degree by the H-B index and the number of liquid evacuations by the ambulatorial evaluation (p=0.013). The anthropometric data evidenced the increase of the current weight (p=0.043), of the change of the % of the habitual weight (p=0.03), of the BMI (p=0.043), of the AC (p=0.016). With relationship to the nutritional status (NS) classification, it has been identified differences on the suitability percentage of TST, without differences affecting to the additional parameters. The sampling of seric ALB, ESR and CRP did not present any changes. The application of PROLB allowed the improvement of clinic parameters related to the disease activity, to the number of liquid evacuations and to the anthropometric parameters related to the current weight, to the BMI, to the AC, and to the classification of NS by TST

ASSUNTO(S)

probioticos doença de avaliação nutricional crohn probiotics malnutrition assessment desnutrição crohn s disease

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