Proesmans M, De Boeck K
Department of Pediatric Pulmonology, University Hospital of Leuven, Belgium.
J Pediatr Gastroenterol Nutr. 2002 Nov;35(5):610-4. doi: 10.1097/00005176-200211000-00004.
Pancreatic enzyme replacement is the cornerstone of treating pancreatic insufficiency in patients with cystic fibrosis. Additionally, a high-calorie/high-fat diet is required to compensate for the increased energy requirement and the incomplete fat digestion. Even with adequate enzyme treatment, gastrointestinal problems, varying from simple constipation to inspissated stools, and distal intestinal obstruction syndrome (DIOS) may occur. Apart from residual fat malabsorption, a low fiber intake is suspected to be an underlying factor in gastrointestinal complaints.
We evaluated fiber intake in 40 patients with cystic fibrosis based on the dietary history method. Patients were classified according to gastrointestinal problems: group 1, no gastrointestinal complaints; group 2, nonspecific and mild gastrointestinal complaints; and group 3, documented DIOS.
Overall fiber intake was adequate when compared with current recommendations. We could not show a relation between fiber intake and gastrointestinal complaints or DIOS. On the contrary, in patients with DIOS, fiber intake was higher, possibly as a therapeutic response to their gastrointestinal complaints.
Overall fiber intake is adequate in our cystic fibrosis population. We could show no relation between low fiber intake and gastrointestinal problems in our patients with cystic fibrosis.
胰腺酶替代疗法是治疗囊性纤维化患者胰腺功能不全的基石。此外,需要高热量/高脂肪饮食来补偿增加的能量需求以及脂肪消化不完全的情况。即使进行了充分的酶治疗,仍可能出现从单纯便秘到粪便干结等各种胃肠道问题,以及远端肠梗阻综合征(DIOS)。除了残留脂肪吸收不良外,低纤维摄入量被怀疑是胃肠道不适的一个潜在因素。
我们基于饮食史方法评估了40例囊性纤维化患者的纤维摄入量。根据胃肠道问题对患者进行分类:第1组,无胃肠道不适;第2组,非特异性轻度胃肠道不适;第3组,确诊为DIOS。
与当前建议相比,总体纤维摄入量充足。我们未能发现纤维摄入量与胃肠道不适或DIOS之间存在关联。相反,在患有DIOS的患者中,纤维摄入量较高,这可能是对其胃肠道不适的一种治疗反应。
在我们的囊性纤维化患者群体中,总体纤维摄入量充足。我们未能发现低纤维摄入量与囊性纤维化患者的胃肠道问题之间存在关联。