University of Adelaide Discipline of Medicine and Centre of Clinical Research Excellence in Nutritional Physiology, Interventions and Outcomes, Royal Adelaide Hospital, Adelaide, SA 5000, Australia.
Nat Rev Gastroenterol Hepatol. 2013 Mar;10(3):150-7. doi: 10.1038/nrgastro.2012.246. Epub 2013 Jan 8.
Dietary factors are increasingly recognized to have an important role in triggering symptoms in a large proportion of patients with functional dyspepsia. Fatty foods seem to be the main culprits, but other foods (including carbohydrate-containing foods, milk and dairy products, citrus fruits, spicy foods, coffee and alcohol) have also been implicated. However, blind challenge tests do not provide consistent results. Moreover, although patients identify specific foods as triggers of their symptoms, these patients often do not seem to make behavioural adjustments in an attempt to improve symptoms; that is, any differences in dietary intake and lifestyle between patients and healthy individuals are small. Patients with functional dyspepsia exhibit mixed sensory-motor abnormalities, such as gastric hypersensitivity and impaired gastric accommodation of a meal. Nutrients, particularly fat, exacerbate these abnormalities and might thereby trigger postprandial symptoms. Cognitive factors, including anticipation related to previous negative experience with certain foods, might also have a role in triggering symptoms. Studies evaluating the potential beneficial effect of dietary interventions and changes in lifestyle are lacking, and this Review outlines a number of options that could be used as starting points for meaningful large-scale studies in the future.
饮食因素在很大一部分功能性消化不良患者的症状触发中起着重要作用，这一点正日益得到人们的认可。脂肪类食物似乎是主要的罪魁祸首，但其他食物（包括含碳水化合物的食物、牛奶和乳制品、柑橘类水果、辛辣食物、咖啡和酒精）也与此有关。然而，盲目挑战测试并不能提供一致的结果。此外，尽管患者会确定特定的食物是引发其症状的原因，但这些患者似乎并没有试图做出行为上的调整来改善症状；也就是说，患者与健康个体之间的饮食摄入和生活方式差异很小。功能性消化不良患者表现出混合的感觉运动异常，例如胃敏感性增加和餐后胃容纳能力受损。营养素，特别是脂肪，会加重这些异常，从而可能引发餐后症状。认知因素，包括与以前对某些食物的负面经历相关的预期，也可能在触发症状方面发挥作用。目前缺乏评估饮食干预和生活方式改变的潜在有益效果的研究，本综述概述了一些可能作为未来有意义的大规模研究起点的选择。
