Nuffield Health The Manor Hospital, Oxford, UK Department of Nutrition and Dietetics, Royal Sussex County Hospital, Brighton, UK.
J Hum Nutr Diet. 2012 Jun;25(3):260-74. doi: 10.1111/j.1365-277X.2012.01242.x. Epub 2012 Apr 10.
BACKGROUND: Irritable bowel syndrome (IBS) is a chronic debilitating functional gastrointestinal disorder. Diet and lifestyle changes are important management strategies. The aim of these guidelines is to systematically review key aspects of the dietary management of IBS, with the aim of providing evidence-based guidelines for use by registered dietitians. METHODS: Questions relating to diet and IBS symptom management were developed by a guideline development group. These included the role of milk and lactose, nonstarch polysaccharides (NSP), fermentable carbohydrates in abdominal bloating, probiotics and empirical or elimination diets. A comprehensive literature search was conducted and relevant studies from January 1985 to November 2009 were identified using the electronic database search engines: Cinahl, Cochrane Library, Embase, Medline, Scopus and Web of Science. Evidence statements, recommendations, good practice points and research recommendations were developed. RESULTS: Thirty studies were critically appraised. A dietetic care pathway was produced following a logical sequence of treatment and formed the basis of these guidelines. Three lines of dietary management were identified. first line: Clinical and dietary assessment, healthy eating and lifestyle management with some general advice on lactose and NSP. Second line: Advanced dietary interventions to improve symptoms based on NSP, fermentable carbohydrates and probiotics. Third line: Elimination and empirical diets. Research recommendations were also identified relating to the need for adequately powered and well designed randomised controlled trials. CONCLUSIONS: These guidelines provide evidence-based details of how to achieve the successful dietary management of IBS.
背景:肠易激综合征(IBS)是一种慢性衰弱性功能性胃肠道疾病。饮食和生活方式的改变是重要的管理策略。本指南的目的是系统地回顾 IBS 饮食管理的关键方面,旨在为注册营养师提供循证指南。
方法:由指南制定小组制定了与饮食和 IBS 症状管理相关的问题。这些问题包括牛奶和乳糖、非淀粉多糖(NSP)、可发酵碳水化合物在腹胀中的作用、益生菌和经验性或排除饮食。使用电子数据库搜索引擎进行了全面的文献检索,并确定了从 1985 年 1 月至 2009 年 11 月的相关研究:Cinahl、Cochrane 图书馆、Embase、Medline、Scopus 和 Web of Science。制定了证据陈述、建议、良好实践要点和研究建议。
结果:对 30 项研究进行了批判性评价。根据治疗的逻辑顺序制定了饮食护理路径,并以此为这些指南的基础。确定了三条饮食管理线。一线:临床和饮食评估、健康饮食和生活方式管理,以及关于乳糖和 NSP 的一些一般建议。二线:基于 NSP、可发酵碳水化合物和益生菌的高级饮食干预以改善症状。三线:排除和经验性饮食。还确定了与需要进行充分功率和精心设计的随机对照试验相关的研究建议。
结论:这些指南提供了关于如何成功管理 IBS 饮食的循证细节。
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