Associação entre ingestão de lactose e doença do refluxo gastroesofágico: um estudo de coorte

Abstract

Gastroesophageal reflux disease (GERD) is a clinical condition caused by the return of acidic stomach content to the esophagus, leading to heartburn. Considering that transient relaxation of the lower esophageal sphincter may be more frequent due to the fermentation of carbohydrates in the intestinal lumen, the aim of this experimental exploratory study was to evaluate the association between milk intake and the occurrence of heartburn in patients with GERD. Patients with a diagnosis confirmed by endoscopy were included, and were randomly divided into two groups, so that one group consumed milk for five days, while the other group consumed tea in their diet, with the groups being reversed in the subsequent week. The results showed that the average number of heartburn events per day was 0.84 ± 0.63. The participants’ average heartburn rate was higher in the period in which milk was consumed compared to tea (0.98 ± 0.75 events per day vs. 0.71 ± 0.70; p = 0.016). Body mass index (BMI) presented a significant influence, with heartburn exacerbation in the obese when milk was consumed. There was also an increase (p = 0.043) in the frequency of use of antacid medication during the week with milk intake. Finally, the odds ratio for the occurrence of total heartburn due to milk intake was 2.83 (95% confidence interval: 1.02 to 7.87). It is concluded that patients with GERD are 183% more likely to experience heartburn when they consume milk than when they consume tea. This clinical finding reinforces the pathophysiological concept that dairy intake worsens gastroesophageal reflux, and an individualized clinical assessment is important for a more adequate adaptation of the diet and improved quality of life