Pilipenko V I, Burliaeva E A, Isakov V A
Vopr Pitan. 2013;82(1):64-73.
Irritable bowel syndrome (IBS) is the most prevalent functional disease of the gastrointestinal tract. This highly prevalent condition is best diagnosed by assessing the constellation of symptoms with which patients present to their physicians. Because some critics have previously questioned whether irritable bowel syndrome and other functional gastrointestinal disorders truly exist because they do not have defining structural features, the Rome Foundation fostered the use of symptom-based criteria for universal use. In most cases treatment is reduced to symptomatic therapy because a lot of unknown in pathogenesis by irritable bowel syndrome. Irritable bowel syndrome leads to decrease of quality of life of the patients and could be one of the reasons of patients' disability. Food is believed by patients promotes symptoms and the diet or avoiding specific food can reduce symptoms. Possible role of different food and microbiota in the pathophysiology of irritable bowel syndrome, as well as the data from randomized, controlled clinical trials dedicated to the effects of diet in irritable bowel syndrome are summarized and discussed in this review. The efficacy of the diet, enriched by fiber, prebiotics, probiotics, peppermint oil, curcumin and vitamin B6 in irritable bowel syndrome patients was shown in numerous studies. In some studies restriction in consumption of fermented carbohydrates, coffee and alcohol, as well as diet with elimination IgG-sensed food was also shown to be effective in irritable bowel syndrome. Food intolerances, defined as non-toxic non-immune adverse reactions to food, include reactions to bioactive chemicals in foods and metabolic reactions to poorly absorbed dietary carbohydrates. New dietary approaches like polyunsaturated fatty acids intake correction and the low tryptophan intake are discussed.
肠易激综合征(IBS)是胃肠道最常见的功能性疾病。这种高度常见的病症最好通过评估患者向医生呈现的一系列症状来诊断。由于一些批评者此前质疑肠易激综合征和其他功能性胃肠疾病是否真的存在,因为它们没有明确的结构特征,罗马基金会倡导使用基于症状的标准以供普遍使用。在大多数情况下,治疗只能采用对症治疗,因为肠易激综合征的发病机制中有很多未知因素。肠易激综合征会导致患者生活质量下降,可能是患者残疾的原因之一。患者认为食物会加重症状,而饮食调整或避免特定食物可以减轻症状。本文综述并讨论了不同食物和微生物群在肠易激综合征病理生理学中的可能作用,以及专门针对饮食对肠易激综合征影响的随机对照临床试验数据。许多研究表明,富含纤维、益生元、益生菌、薄荷油、姜黄素和维生素B6的饮食对肠易激综合征患者有效。在一些研究中,限制食用发酵碳水化合物、咖啡和酒精,以及排除IgG致敏食物的饮食也被证明对肠易激综合征有效。食物不耐受被定义为对食物的无毒非免疫不良反应,包括对食物中生物活性化学物质的反应和对吸收不良的膳食碳水化合物的代谢反应。本文还讨论了多不饱和脂肪酸摄入调整和低色氨酸摄入等新的饮食方法。