77 ENVIRONMENTAL ENTEROPATHY IN CHILE

Abstract

In tropical countries with poor environmental sanitation mild to severe non specific changes in the small intestinal morphology and function have been described. This study was carried out to investigate whether similar changes occur in countries of temperate climate and poor sanitation. Fifteen young healthy volunteers, who belonged to the lowest socioeconomic stratus were studied. They live in periurban slums in Santiago, where high contamination indexes prevail. Evaluation of the nutritional status (physical examination, anthropometry, biochemical), intestinal function (serum carotene and vit.A. blood xylose after 5g oral standard dose, disaccharidases, duodenal biopsy, nitrogen and fat balance), stool parasites and stool culture were performed. Nutritional status was normal in all cases.One subject had serum carotene below 60ug%. One hour blood xylose was below 20mg% in 67% of cases. Serum vitamin A and disaccharidases were normal in all cases. G. Lamblia and/or Ent.Hystolitica were obtained the stools in 7 subjects. Stool cultures was negative in all cases. Light microscopy of the mucosa showed mild unspecific changes. Electron microscopy revealed mild to moderate patchy changes in the brushborder and basal membrane Nitrogen and fat balance were normal in all cases. Mild nonspecific changes of the small intestinal morphology and function suggest a mild environmental enteropathy of lesser magnitude than those described in tropical countries.