Perfil diagnóstico de intolerância à lactose, alergia à proteína do leite de vaca e distúrbios gastrointestinais funcionais em um ambulatório de especialidade

Abstract

Introduction: Currently, it is still a challenge for many pediatricians and general practitioners to differentiate and diagnose the different functional gastrointestinal disorders and pathologies such as Lactose Intolerance (LI) and Cow's Milk Protein Allergy (CMPA). Despite well-defined criteria, the similarity of symptoms between these entities generates mistakes during diagnostic elucidation through clinical history, leading to the request for excessive complementary tests and/or unnecessary dietary restrictions. In the literature, it is clear that there is a gap in information that simultaneously compares this group of pathologies. Objective: to evaluate the equivalence of the initial and final diagnostic hypotheses of children referred to the Pediatric Gastroenterology Outpatient Clinic of the Hospital Universitário de Lagarto in the period from 2021 to 2022 Methods: This is an observational, descriptive, cross-sectional, retrospective study, based on data from medical records. The research was developed at the Pediatric Gastroenterology Outpatient Clinic of the University Hospital of Lagarto, involving an analysis of electronic medical records of 404 patients treated in the current period, in order to quantify and describe the study variables. A confidence level of 95% and a “p” of less than 0.05 were considered. Results: Of the 404, 99 (N) individuals were included, of whom had been referred due to suspected CMPA, IL or symptoms that could be associated with these two pathologies. Among N, 55 (55.6%) were diagnosed with functional gastrointestinal disorders (DGF), 24 (24.3%) with lactose intolerance (IL), 11 (11.1%) with milk protein allergy (APLV) and 9 (9%) received another diagnostic hypothesis (another disorder/dysfunction). Of the DGFs, functional constipation was the most common disorder (81.8%). Conclusion: There was a good equivalence between the final diagnoses established and the referrals with initial hypotheses of CMPA, IL or the presence of other gastrointestinal symptoms, mainly in relation to Functional Gastrointestinal Disorders. However, some professionals still end up requesting unnecessary tests and subjecting patients to unnecessarily restricted diets.