Intestinal alterations in people with rheumatoid arthritis
DOI:
https://doi.org/10.33448/rsd-v11i11.33968Keywords:
Rheumatoid arthritis; Feeding habits; Signs and symptoms, Digestive; Autoimmune diseases; Gastrointestinal microbiome.Abstract
Objective: This study aimed to analyze the main intestinal changes in people with Rheumatoid Arthritis (RA) and aspects related to them, highlighting the influence of alimentary changes resulting from intestinal symptoms (IS). Methods: Quantitative data were collected regarding age group, RA time of diagnosis, evacuation profile, IS, the influence of food on symptoms and socioeconomic aspects through the implementation of an adapted validated questionnaire (Souza et al., 2016) in groups of virtual social networks. Crosses between these data were performed to better clarify the main factors involved in this correlation. The results were calculated using the Statistical Packages of the Social Sciences® program. Results: 91 people with RA participated, with a mean age of 46,9 years. 96,7% were female and 3,3% male. An emphatic occurrence of IS in RA patients was revealed. The main symptoms reported were abdominal pain, nausea, flatulence, constipation and diarrhea. There was a significant prevalence of abdominal pain when relating IS with age group. 97,8% said they used medicinal drugs to treat RA and 2,2% denied. As a result of the IS, in which “constipation” and “nausea” were statistically significant, 68% reported changes in alimentation. The results also showed independence between IS and the socioeconomic profile of the respondents. Conclusion: A high prevalence of intestinal alterations in RA patients and alimentary changes as a result of IS was verified.
References
Anjos, A. C. P. de A. dos, Andrade, M. V. F. de, Santos, A. C. M., Bezerra, D. M., Júnior, M. A. F. & Jesus J. R. de (2021). Influência da deficiência de vitamina D sobre a disbiose intestinal: Uma revisão sistemática. Research, Society and Development. 10(9), e24610916596. https://doi.org/10.33448/rsd-v10i9.16596. https://rsdjournal.org/index.php/rsd/article/view/16596.
Asai, S., Nagai, K., Takahashi, N., Watanabe, T., Matsumoto, T., Asai, N., Sobue, Y., Ishiguro, N. & Kojima, T. (2018). Influence of methotrexate on gastrointestinal symptoms in patients with rheumatoid arthritis. International Journal of Rheumatic Diseases. 22(2), 207–213. https://www.doi.org/10.1111/1756-185X.13380. https://pubmed.ncbi.nlm.nih.gov/30168274/.
Attur, M., Scher, J. U., Abramson, S. B. & Attur, M. (2022). Role of Intestinal Dysbiosis and Nutrition in Rheumatoid Arthritis. Cells, 11(15), 2436. https://doi.org/10.3390/cells11152436. https://www.mdpi.com/2073-4409/11/15/2436/htm.
Awarith, J., Kahleova, H., Rembert, E., Yonas, W., Dort, S., Calcagno, M., Burgess, N., Crosby, L. & Barnard, N. D. (2019). Nutrition Intervention in Rheumatoid Arthritis: The Potencial Use of Plant-Based Diets. A Review. Frontiers in Nutrition. 6(141). https://doi.org/10.3389/fnut.2019.00141. https://www.frontiersin.org/articles/10.3389/fnut.2019.00141/full.
Brandão, P. L. K. O., Filho, S. T. de A., Santos, J. G. C. dos, Junior, M. P. B., Lessa, G. P. dos S. S., Pascoal, D. B. & Cruz, C. M. da (2020). Estudo Comparativo das Doenças Inflamatórias Articulares Espondilite Anquilosante e Artrite Reumatóide. Brazilian Applied Science Review. 4(4), 2258–2268. https://doi.org/10.34115/basrv4n4-011. https://www.brazilianjournals.com/index.php/BASR/article/view/13045/10957.
Bueno, J., Gebara, T. S. S. & Coradine, A. V. P. (2022). Avaliação da efetividade da dieta isenta de glúten na diminuição da sintomatologia de doenças autoimunes. Revista de Saúde Pública do Paraná. 5(1), 30–43. https://doi.org/10.32811/25954482-2022v5n1p30. http://revista.escoladesaude.pr.gov.br/index.php/rspp/article/view/564.
Cafiero, C., Re, A., Pisconti, S., Trombetti, M., Perri, M., Colosimo, M., D'amato, G., Gallelli, L., Cannataro, R., Molinario, C., Fazio, A., Caroleo, M. C. & Cione, E. (2020 lho). Dysbiosis in intestinal microbiome linked to fecal blood determined by direct hybridization. 3 Biotech. 10(8), 358. https://doi.org/10.1007%2Fs13205-020-02351-w. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387388/.
Daien, C., Czernichow, S., Letarouilly, J. G., Nguyen, Y., Sanchez P., Sigaux, J., Beauvais, C., Desouches, S., Puillandre, R. L., Rigalleau V., Rivière P., Romon, M., Semerano L., Seror, R., Sfedj, S., Tournadre, A., Vacher, D., Wendling, D., Flipo, R. M. & Sellam, J. (2022). Recommandations de la Société française de rhumatologie sur l’alimentation des patients ayant un rhumatisme inflammatoire chronique. Revue du Rhumatisme. 89(2), 116–127. https://doi.org/10.1016/j.rhum.2021.09.013. https://www.sciencedirect.com/science/article/pii/S1169833021009108?via%3Dihub.
Dias, F. R. S. (2019). Desenvolvimento e validação de métodos analíticos [Monografia, Programa de Pós-graduação em Fármacos e Medicamentos, Faculdade de Ciências Farmacêuticas, Universidade de São Paulo]. https://edisciplinas.usp.br/mod/resource/view.php?id=2565235.
Eguchi, T., Yoshizaki, T., Takagi, M., Ikeoka, S., Hashimura, H., Okamoto N., Matsumoto, M., Matsuda, T., Miura, T., Momose, K., Otsuka, T., Morisawa, T. & Okada, A. (2021). Risk Factors for Adverse Events in Patients with Chronic Constipation Following Lubiprostone Administration. Digestive Diseases. 39, 10–15. https://doi.org/10.1159/000508864. https://www.karger.com/Article/Abstract/508864.
Ferreira, E. G. & Araujo, M. C. de (2022). Disbiose intestinal em estudantes do curso de nutrição de uma universidade da grande Florianópolis. RBONE – Revista Brasileira De Obesidade, Nutrição E Emagrecimento. 14(90, supl. 1), 1240–1248. http://www.rbone.com.br/index.php/rbone/article/view/1547.
Garcia, L. B., Bertolini, S. M. M. G., Souza, M. V. de, Santos, M. S. F. dos & Pereira, C. O. M. (2016). Constipação Intestinal: Aspectos Epidemiológicos e Clínicos. Saúde e Pesquisa. 9(1), 153–162. https://doi.org/10.17765/1983-1870.2016v9n1p153-162. https://periodicos.unicesumar.edu.br/index.php/saudpesq/article/view/4761.
Gatti, B. A. (2004, abril). Estudos quantitativos em educação. Educação e Pesquisa. 30(1), 11-30. https://www.scielo.br/j/ep/a/XBpXkMkBSsbBCrCLWjzyWyB/?lang=pt#. https://doi.org/10.1590/S1517-97022004000100002.
Gibson, P. R., Halmos, E. P., So, D., Yao, C. K., Varney, J. E., & Muir, J. G. (2022, 6 de janeiro). Diet as a therapeutic tool in chronic gastrointestinal disorders: Lessons from the FODMAP journey. Journal of Gastroenterology and Hepatology. 37(4), 644-652. https://doi.org/10.1111/jgh.15772. https://onlinelibrary.wiley.com/doi/full/10.1111/jgh.15772.
Gioia, C., Lucchino, B., Tarsitano, M. G., Iannuccelli, C. & Franco, M. D. (2020, 18 de maio). Dietary Habits and Nutrition in Rheumatoid Arthritis: Can Diet Influence Disease Development and Clinical Manifestations? Nutrients. 12(5), 1456. https://doi.org/10.3390/nu12051456. https://www.mdpi.com/2072-6643/12/5/1456.
Gouveia, H. J. C. B., Urquiza-Martínez, M. V., Manhães-de-Castro, R., Costa-de-Santana, B. J. R., Villarreal, J. P., Mercado-Camargo, R., Torner, L., Aquino, J. de S., Toscano, A. E. & Guzmán-Quevedo, O. (2022, 28 de julho). Effects of the Treatment with Flavonoids on Metabolic Syndrome Components in Humans: A Systematic Review Focusing on Mechanisms of Action. International Journal of Molecular Sciences. (23)15, 8344. https://doi.org/10.3390/ijms23158344. https://www.mdpi.com/1422-0067/23/15/8344/htm.
Guerreiro, C. S., Calado, A, Sousa, J. & Fonseca J. E. (2018, 14 de dezembro). Diet, Microbiota, and Gut Permability—The Unknown Triad in Rheumatoid Arthritis. Frontiers in Medicine. 5(349). https://doi.org/10.3389/fmed.2018.00349. https://www.frontiersin.org/articles/10.3389/fmed.2018.00349/full.
Gupta, V. K., Cunningham, K. Y., Hur, B., Bakshi, U., Huang, H., Warrington, K. J., Taneja, V., Myasoedova, E., Davis III, J. M. & Sung, J. (2021, 14 de setembro). Gut microbial determinants of clinically important improvement in patients with rheumatoid arthritis. Genome Medicine. 13(149). https://doi.org/10.1186/s13073-021-00957-0. https://genomemedicine.biomedcentral.com/articles/10.1186/s13073-021-00957-0.
Häger, J., Bang, H., Hagen, M., Frech, M., Träger, P., Sokolova, M. V., Steffen, U., Tascilar, K., Sarter, K., Schett, G., Rech, J. & Zaiss, M. M. (2019, 7 de outubro). The Role of Dietary Fiber in Rheumatoid Arthritis Patients: A Feasibility Study. Nutrients. 11(10), 2392. https://dx.doi.org/10.3390%2Fnu11102392. https://www.mdpi.com/2072-6643/11/10/2392.
Hayashi, A. A., Ferreira, I. S. C. & Silva M. C. da (2020, 1 de dezembro). Disbiose intestinal e a relação com a patogênese de doenças autoimunes [Monografia, Bacharelado em Nutrição, Faculdade de Ciências da Educação e Saúde, Centro Universitário de Brasília]. Repositório Institucional da UniCEUB. https://repositorio.uniceub.br/jspui/handle/prefix/14413.
Hazlewood, G. S., Schieir, O., Bykerk, V., Mujaab, K., Tugwell, P. & Wells, G., Richards, D., Proulx, L., Hull, P. M. & Barlett, S. J. (2022, 1 de julho). Frequency of symptomatic adverse events in rheumatoid arthritis: an exploratory online survey. The Journal of Rheumatology. 49(5). https://doi.org/10.3899/jrheum.210688. https://www.jrheum.org/content/early/2022/02/24/jrheum.210688.tab-article-info.
Holers, V. M., Kuhn, K. A., Demoruelle, M. K., Norris, J. M., Firestein, G. S., James, E. A., Robinson, W. H., Buckner, J. H. & Deane, K. D. (2022, 15 de junho). Mechanism-driven strategies for prevention of rheumatoid arthritis. Rheumatology & Autoimmunity. 1(11). https://doi.org/10.1002/rai2.12043. https://onlinelibrary.wiley.com/doi/10.1002/rai2.12043.
Junior, A. S., Boulhosa, R. H., Frazão, J. J. T., Medeiros, J. B., Sauma, M. L. & Sauma, M. F. L. & Carneiro, J. R. M. (2017). Artrite reumatoide na vida real: características demográficas, clínicas e avaliação da capacidade funcional e qualidade de vida de 100 pacientes da FSCMPA. Revista Brasileira de Reumatologia. 57(supl. 1), S5. https://doi.org/10.1016/j.rbr.2017.06.011. https://www.sciencedirect.com/science/article/pii/S0482500417302036.
Kamphuis, J. B. J., Reber, L., Eutamène, H. & Theodorou, V. (2022, 8 de abril). Increased fermentable carbohydrate intake alters colonic mucus barrier function through glycation processes and increased mast cell counts. The FASEB Journal. 36(5), e22297. https://doi.org/10.1096/fj.202100494RRR. https://faseb.onlinelibrary.wiley.com/doi/full/10.1096/fj.202100494RRR.
Ke, Y., Dai, X., Xu, D., Liang, J., Yu, Y., Cao, H., Chen, W. & Lin, J. (2021, 14 de dezembro). Features and Outcomes of Elderly Rheumatoid Arthritis: Does the Age of Onset Matter? A Comparative Study From a Single Center in China. Rheumatology and Therapy. 8, 243–254. https://doi.org/10.1007/s40744-020-00267-8. https://link.springer.com/article/10.1007/s40744-020-00267-8.
Khanna, S., Jaiswal, K. S. & Gupta, B. (2017, 8 de novembro) Managing Rheumatoid Arthritis with Dietary Interventions. Frontiers in Nutrition. 4(52). https://doi.org/10.3389/fnut.2017.00052. https://www.frontiersin.org/articles/10.3389/fnut.2017.00052/full.
Lewis, S. J. & Heaton, K. W. (1997, recebido em 4 de abril). Stool Form Scale as a Useful Guide to Intestinal Transit Time. Scandinavian Journal of Gastroenterology. 32(9), 920–924. https://doi.org/10.3109/00365529709011203. https://www.tandfonline.com/doi/abs/10.3109/00365529709011203.
Lin Y. J., Anzaghe, M. & Schülke, S. (2020, 3 de abril). Update on the Pathomechanism, Diagnosis, and Treatment Options for Rheumatoid Arthritis. Cells, 9(4), 880. https://dx.doi.org/10.3390%2Fcells9040880. https://www.mdpi.com/2073-4409/9/4/880.
Martinez, A. P. & Azevedo, G. R. de (2012, junho). The Bristol Stool Form Scale: its translation to Portuguese, cultural adaptation and validation. Revista Latino-Americana de Enfermagem. 20(3), 583–589. https://doi.org/10.1590/S0104-11692012000300021. https://www.scielo.br/j/rlae/a/vDBpwytKNhBsLbzyYkPygFq/?lang=en#.
Masuko, K. A. (2018, 15 de maio). Potential Benefit of “Balanced Diet” for Rheumatoid Arthritis. Frontiers in Medicine. 5(2), 1–5. https://doi.org/10.3389/fmed.2018.00141. https://www.frontiersin.org/articles/10.3389/fmed.2018.00141/full.
Matei, D. E., Menon, M., Alber, D. G., Smith, A. M., Shokouhi-Nedjat, B., Fasano, A., Magill, L., Duhlin, A., Bitoun, S., Gleizes, A., Hacein-Bey-Abina, S., Manson, J. J., Rosser, E. C., Klein, N., Blair, P. A. & Mauri, C. (2021, 13 de maio). Intestinal barrier dysfunction plays an integral role in arthritis pathology and can be targeted to ameliorate disease. Med. 2(7), 864–883. https://doi.org/10.1016/j.medj.2021.04.013. https://www.cell.com/med/fulltext/S2666-6340(21)00162-8?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS2666634021001628%3Fshowall%3Dtrue.
Miranda, J. F., Araújo, M. P. de & Oliveira, K. G. Z. (2022, 15 de janeiro). O homem na busca dos serviços de atenção primária em saúde na cidade de Imperatriz-MA. Research, Society and Development. 11(1), e56011124946. http://dx.doi.org/10.33448/rsd-v11i1.24946. https://rsdjournal.org/index.php/rsd/article/view/24946.
Morais Y. B., Santos I. C. L. dos, Ferreira T. da S. & Neves F. J. das (2020, 29 de julho). Evolução do estado nutricional e sintomatologia de indivíduos com doença inflamatória intestinal. SEMEAR: Revista de Alimentação, Nutrição e Saúde. 2(1), 1–12. http://www.seer.unirio.br/ralnuts/article/view/10175#:~:text=Resumo,melhora%20do%20quadro%20e%20progn%C3%B3stico.
Nagayoshi, B. A., Lourenção, L. G., Kobayase, Y. N. S., Paula, P. M. da S. & Miyazaki, M. C. de O. S. (2018, janeiro a fevereiro). Artrite Reumatoide: perfil de pacientes e sobrecarga de cuidadores. Revista Brasileira de Geriatria e Gerontologia. 21(1), 45–53. https://doi.org/10.1590/1981-22562018021.170103. https://www.scielo.br/j/rbgg/a/rrrjvycVW9G6WdPbSVPzxjb/?lang=en.
NeuHannig, C., Régis, C. dos P., Soika J. H., Silva, L. A. de S., Quintanilha, V. A. B., Bussolotto L. T., Vicentini, M. S. & Bello, S. R. B. (2019, 29 de março). Disbiose Intestinal: Correlação com doenças crônicas da atualidade e intervenção nutricional. Research, Society and Development. 8(6). https://doi.org/10.33448/rsd-v8i6.1054. https://rsdjournal.org/index.php/rsd/article/view/1054.
Oliveira, M. F. de (2011). Metodologia científica: um manual para a realização de pesquisas em administração [Pós-graduação, Universidade Federal de Goiás]. Biblioteca da UFG. https://files.cercomp.ufg.br/weby/up/567/o/Manual_de_metodologia_cientifica_-_Prof_Maxwell.pdf.
Oliveira, M. T., Campos-Pereira, F. D. O. O. (2021, 6 de maio). O impacto da microbiota intestinal na artrite reumatóide. In Barbosa, A. K. da S. (Org.), Nutrição Experimental e Clínica e sua Ação Transformadora. 2, pp. 176–184. https://doi.org/10.22533/at.ed.65721060519. https://www.atenaeditora.com.br/post-artigo/51587.
Ospelt, C. & Gay, S. (2022, 14 de abril). Epigenetic Epidemiology of Inflammation and Rheumatoid Arthritis. In K. B. Michels (Ed.), Epigenetic Epidemiology. pp. 363–380. Springer, Cham. https://doi.org/10.1007/978-3-030-94475-9_15. https://link.springer.com/chapter/10.1007/978-3-030-94475-9_15.
Pantoja, C. L., Costa, A. C. C., Costa, P. L. de S., Andrade, M. de A. H., Silva V. V., Brito A. P. S. O. & Garcia, H. C. R. (2019, 7 de outubro). Diagnóstico e tratamento da disbiose: Revisão Sistemática. Revista Eletrônica Acervo Saúde. 32(32), e1368. https://doi.org/10.25248/reas.e1368.2019. https://acervomais.com.br/index.php/saude/article/view/1368.
Passos, M. do C. F., Alvariz, R. C., André, E. A., Barbuti, R. C., Fillmann, H. S., Murad-Regadas, S. M., Filho, J. R., Perrotti, M. & Guedes, L. (2022, janeiro a março). Diagnosis and management of chronic idiopathic constipation: a narrative review from a Brazilian expert task force. Arquivos de Gastroenterologia. 59(1), 137–144. https://doi.org/10.1590/S0004-2803.202200001-23. https://www.scielo.br/j/ag/a/zwRh8ZSwMnsdFMJZVTHv8Dj/abstract/?lang=en#.
Paul, B.J., Kandy, H. I. & Krishnan, V. (2019, 3 de setembro). Pre-rheumatoid arthritis and its prevention. European Journal of Rheumatology. 4(2), 161-165. https://doi.org/10.5152/eurjrheum.2017.16006. https://eurjrheumatol.org//en/pre-rheumatoid-arthritis-and-its-prevention-132936.
Raad, T., George, E., Griffin A., Larkin, L., Fraser, A., Kennedy, N. & Tierney, A. (2022, agosto). A randomised controlled trial of a Mediterranean Dietary Intervention for Adults with Rheumatoid Arthritis (MEDRA): Study protocol. Contemporary Clinical Trials Communications. 8. https://doi.org/10.1016/j.conctc.2022.100919. https://www.sciencedirect.com/science/article/pii/S2451865422000369.
Rempenault, C., Lukas, C., Combe, B., Herrero, A., Pane, I., Schaeverbeke, T., Wendling, D., Pham, T., Gottenberg, J. E., Mariette, X. & Morel, J. (2022, março). Risk of diverticulitis and gastrointestinal perforation in rheumatoid arthritis treated with tocilizumab compared to rituximab or abatacept. Rheumatology, 61(3), 953–962. https://doi.org/10.1093/rheumatology/keab438. https://academic.oup.com/rheumatology/article-abstract/61/3/953/6276446?login=false.
Rose, J. (2022). Autoimmune Connective Tissue Diseases: Systemic Lupus Erythematosus and Rheumatoid Arthritis. Emergency Medicine Clinics. 40(1), 179–191. https://doi.org/10.1016/j.emc.2021.09.003. https://www.emed.theclinics.com/article/S0733-8627(21)00099-7/fulltext#relatedArticles.
Scher J. U., Littman D. R. & Abransom S. B. (2016). Microbiome in Inflammatory Arthritis and Human Rheumatic Diseases. Arthritis & Rheumatology. 68(1), 35–45. https://doi.org/10.1002/art.39259. https://onlinelibrary.wiley.com/doi/10.1002/art.39259.
Silva, A. K. L. C. P. da, Pereira, P. M. de L., Seixas, T. B. & Percegoni, N. (2020). Constipação intestinal e fatores associados em pacientes internados em um hospital universitário. Revista da Associação Brasileira de Nutrição. 11(1), 72–85. https://doi.org/10.47320/rasbran.2020.1753. https://www.rasbran.com.br/rasbran/article/view/1753.
Silva, D. R da (2019). Aspectos clínicos, diagnóstico, terapêutico e qualidade de vida de pacientes com artrite reumatoide [Monografia, Bacharelado em Enfermagem, Centro de Formação de Professores, Universidade Federal de Campina Grande]. Biblioteca Digital de Teses e Dissertações da UFCG. http://dspace.sti.ufcg.edu.br:8080/jspui/handle/riufcg/8516.
Silva, G. D. da, Andrade, E. I. G., Cherchiglia, M. L., Almeida, A. M., Júnior, A. F. G. & Acurcio, F. de A. (2018). Perfil de gastos com o tratamento da Artrite Reumatoide para pacientes do Sistema Único de Saúde em Minas Gerais, Brasil, de 2008 a 2013. Ciência & Saúde Coletiva. 23(4). https://doi.org/10.1590/1413-81232018234.16352016. https://www.scielosp.org/article/csc/2018.v23n4/1241-1253/.
Silva, J. A. T. da, Lima, M. J. de, Elias, B. K. & Silva, N. M. M. G. (2021). Percepções sobre o autocuidado masculino: uma revisão da literatura. Brazilian Journal of Development. 7(2), 20766–20777. https://doi.org/10.34117/bjdv7n2-631. https://www.brazilianjournals.com/index.php/BRJD/article/view/25440.
Silva, L. C. (2021). Terapêutica antioxidante ortomolecular como estratégia para uma saúde equilibrada. Brazilian Journal of Health Review. 4(4), 16370–16392. https://doi.org/10.34119/bjhrv4n4-155. https://brazilianjournals.com/index.php/BJHR/article/view/33865.
Souza, G. S., Sardá, F. A. H., Giuntini, E. B., Gumbrevicus, I., Morais M. B. de & Menezes E.W. de (2016). Translation and validation of a Brazilian version of the Gastrointestinal Symptom Rating Scale (GSRS) questionnaire. Arquivos de Gastroenterologia. 53(3), 146–151. https://doi.org/10.1590/S0004-28032016000300005. https://www.scielo.br/j/ag/a/8xF75fBCGY4dwdh8VQD9Bxq/?lang=en.
Souza, L. L. B., Leite, L. de O. & Nepomuceno, C. M. M. (2020). Associação entre enxaqueca, constipação intestinal e intolerância à lactose em adultos. Brazilian Journal of Pain. 3(2), 118–122. https://doi.org/10.5935/2595-0118.20200020. https://www.scielo.br/j/brjp/a/pXwZw3N6Bfnp9VJJtTQSfbx/?lang=pt&format=html#ModalArticles.
Souza, M. A. da S. de, Luciano, A. V. & Silva, J. M. da (2022). Flavonoides como anti-ínflamatórios naturais em inflamações aguda nos pacientes com artrite reumatoide. Scientia Generalis. 3(1), 173–183. http://scientiageneralis.com.br/index.php/SG/article/view/395.
Sun, X., Wang, Y., Li, X., Wang, M., Dong, J., Tang, W., Lei, Z., Guo, Y., Li, M. & Li, Y. (2022). Alterations of gut fungal microbiota in patients with rheumatoid arthritis. PeerJ. 10, e13037. https://doi.org/10.7717/peerj.13037. https://peerj.com/articles/13037/.
Svedlund, J., Sjödin, I. & Dotevall, G. (1988). GSRS—A clinical rating scale for gastrointestinal symptoms in patients with irritable bowel syndrome and peptic ulcer disease. Digestive Diseases and Sciences. 33, 129–134. https://doi.org/10.1007/BF01535722. https://link.springer.com/article/10.1007/BF01535722#citeas.
Swidsinski, A., Loening-Baucke, V., Verstraelen, H., Osowska, S. & Doerffel, Y. (2008). Biostructure of Fecal Microbiota in Healthy Subjects and Patients With Chronic Idiopathic Diarrhea. Gastroenterology. 135(2), 568-579.e2. https://doi.org/10.1053/j.gastro.2008.04.017. https://www.sciencedirect.com/science/article/abs/pii/S0016508508006690.
Vancamelbeke, M. & Vermeire, S. (2017). The intestinal barrier: a fundamental role in health and disease. Expert Review of Gastroenterology & Hepatology. 11(9), 821–834. https://dx.doi.org/10.1080%2F17474124.2017.1343143. https://www.tandfonline.com/doi/full/10.1080/17474124.2017.1343143.
Wang, Y., Wei, J., Zhang, W., Doherty, M., Zhang, Y., Xie, H., Li, W., Wang N., Lei, G. & Zeng, C. (2022). Gut dysbiosis in rheumatic diseases: A systematic review and meta-analysis of 92 observational studies. eBioMedicine. (80), 104055. https://doi.org/10.1016/j.ebiom.2022.104055. https://www.sciencedirect.com/science/article/pii/S2352396422002365.
Weiss, G. A. & Hennet, T. (2017, 28 de março). Mechanisms and consequences of intestinal dysbiosis. Cellular and Molecular Life Sciences. 74 (16), 2959–2977. https://doi.org/10.1007/s00018-017-2509-x. https://link.springer.com/article/10.1007%2Fs00018-017-2509-x.
Wong, M. Y. W., Hebbard, G., Gibson, P. R. & Burgell, R. E. (2020). Chronic constipation and abdominal pain: Independent or closely related symptoms? Journal of Gastroenterology and Hepatology. 35(8), 1294–1301. https://doi.org/10.1111/jgh.14970. https://onlinelibrary.wiley.com/doi/10.1111/jgh.14970.
Zaiss, M. M., Wu, H. J. J., Mauro, D., Schett, G. & Ciccia, F. (2021). The gut-joint axis in rheumatoid arthritis. Nature Reviews Rheumatology. 17(4), 224–237. https://nature.com/articles/s41584-021-00585-3.
Zangirolami-Raimundo, J., Echeimberg, J. de. O. & Leone, C. (2018). Tópicos de metodologia de pesquisa: Estudos de corte transversal. Journal of Human Growth and Development. 28(3), 356-360. https://doi.org/10.7322/jhgd.152198. https://www.revistas.usp.br/jhgd/article/view/152198
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