Department of Medicine, University of Otago, Christchurch, New Zealand.
Int J Clin Pract. 2013 Sep;67(9):895-903. doi: 10.1111/ijcp.12128. Epub 2013 May 23.
Current treatment for irritable bowel syndrome (IBS) is suboptimal. Fermentable oligo-, di-, mono-saccharides and polyols (FODMAPs) may trigger gastrointestinal symptoms in IBS patients. Our aim was to determine whether a low FODMAP diet improves symptoms in IBS patients.
Irritable bowel syndrome patients, who had performed hydrogen/methane breath testing for fructose and lactose malabsorption and had received dietary advice regarding the low FODMAP diet, were included. The effect of low FODMAP diet was prospectively evaluated using a symptom questionnaire. Furthermore, questions about adherence and satisfaction with symptom improvement, dietary advice and diet were assessed.
Ninety patients with a mean follow up of 15.7 months were studied. Most symptoms including abdominal pain, bloating, flatulence and diarrhoea significantly improved (p < 0.001 for all). 75.6%, 37.8% and 13.3% of patients had fructose, lactose malabsorption or small intestinal bacterial overgrowth respectively. Fructose malabsorption was significantly associated with symptom improvement (abdominal pain odds ratio (OR) 7.09 [95% confidence interval (CI) 2.01-25.0], bloating OR 8.71 (95% CI 2.76-27.5), flatulence OR 7.64 (95% CI 2.53-23.0) and diarrhoea OR 3.39 (95% CI 1.17-9.78), p < 0.029 for all). Most patients (75.6%) were adherent to the diet, which was associated with symptom improvement (abdominal pain, bloating, flatulence and diarrhoea all significantly associated with adherence, r > 0.27, p < 0.011). Most patients (72.1%) were satisfied with their symptoms.
The low FODMAP diet shows efficacy for IBS patients. The current strategy of breath testing and dietary advice provides a good basis to understand and adhere to the diet.
目前治疗肠易激综合征（IBS）的效果并不理想。可发酵的寡糖、二糖、单糖和多元醇（FODMAPs）可能会引发 IBS 患者的胃肠道症状。我们的目的是确定低 FODMAP 饮食是否能改善 IBS 患者的症状。
纳入了进行过氢/甲烷呼气试验以检测果糖和乳糖吸收不良并接受过低 FODMAP 饮食饮食建议的 IBS 患者。使用症状问卷前瞻性评估低 FODMAP 饮食的效果。此外，还评估了对饮食建议和饮食的依从性以及对症状改善、饮食建议和饮食的满意度。
研究了 90 例平均随访 15.7 个月的患者。大多数症状，包括腹痛、腹胀、气胀和腹泻，均显著改善（所有症状 p < 0.001）。分别有 75.6%、37.8%和 13.3%的患者存在果糖吸收不良、乳糖吸收不良或小肠细菌过度生长。果糖吸收不良与症状改善显著相关（腹痛的比值比（OR）为 7.09（95%置信区间（CI）为 2.01-25.0），腹胀 OR 为 8.71（95% CI 为 2.76-27.5），气胀 OR 为 7.64（95% CI 为 2.53-23.0），腹泻 OR 为 3.39（95% CI 为 1.17-9.78），所有 p < 0.029）。大多数患者（75.6%）依从饮食，这与症状改善相关（腹痛、腹胀、气胀和腹泻均与依从性显著相关，r > 0.27，p < 0.011）。大多数患者（72.1%）对其症状满意。
低 FODMAP 饮食对 IBS 患者有效。目前的呼气试验和饮食建议策略为理解和遵循饮食提供了良好的基础。
