Division of Gastroenterology, University of Michigan Health System, Ann Arbor, MI 48109-5362, USA.
Am J Gastroenterol. 2013 May;108(5):718-27. doi: 10.1038/ajg.2013.63. Epub 2013 Apr 2.
Despite years of advising patients to alter their dietary and supplementary fiber intake, the evidence surrounding the use of fiber for functional bowel disease is limited. This paper outlines the organization of fiber types and highlights the importance of assessing the fermentation characteristics of each fiber type when choosing a suitable strategy for patients. Fiber undergoes partial or total fermentation in the distal small bowel and colon leading to the production of short-chain fatty acids and gas, thereby affecting gastrointestinal function and sensation. When fiber is recommended for functional bowel disease, use of a soluble supplement such as ispaghula/psyllium is best supported by the available evidence. Even when used judiciously, fiber can exacerbate abdominal distension, flatulence, constipation, and diarrhea.
尽管多年来一直建议患者改变饮食和补充纤维的摄入量，但纤维在功能性肠病中的应用证据有限。本文概述了纤维类型的组织，并强调了在为患者选择合适的策略时评估每种纤维类型发酵特性的重要性。纤维在远端小肠和结肠中进行部分或完全发酵，导致短链脂肪酸和气体的产生，从而影响胃肠道功能和感觉。当推荐纤维用于功能性肠病时，现有证据最好支持使用可溶性补充剂，如车前子/洋车前子。即使谨慎使用，纤维也会加重腹胀、气胀、便秘和腹泻。
