Huamán José Wálter, Felip Ana, Guedea Elena, Jansana Marta, Videla Sebastián, Saperas Esteban
Servicio de Aparato Digestivo, Hospital General de Catalunya, Universidad Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, España.
Servicio de Endocrinología, Hospital General de Catalunya, Sant Cugat del Vallès, Barcelona, España.
Gastroenterol Hepatol. 2015 Mar;38(3):113-22. doi: 10.1016/j.gastrohep.2014.08.007. Epub 2014 Nov 6.
Successful treatment of patients with irritable bowel syndrome (IBS) often remains elusive. Recent studies in Australia, the United Kingdom and New Zealand have suggested the efficacy of a diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) in the management of these patients. The aims of this study were to determine whether a diet low in FODMAPs improves symptoms in patients with functional gastrointestinal disorders (FGID) in Spain and to analyze the predictors of a good response.
A prospective study was carried out in consecutive patients with FGID type IBS and functioanl abdominal bloating. At inclusion all patients underwent an assessment through a baseline demographic questionnaire of symptoms of anxiety and depression and quality of life. A hydrogen breath test with lactose and fructose was performed and a low FODMAPs diet was indicated for 2 months by expert dietitians. These tests were taken as a reference. A positive response was defined as an improvement of at least 5 points out of a possible 10 in the symptom questionnaire.
We included 30 patients (24 women, 39 [12] years). The response to the low FODMAPs diet was positive in controlling overall symptoms and specific symptoms such as functioanl abdominal bloating, abdominal pain, diarrhea, flatulence, nausea and fatigue in more than 70% of patients (P<.05). By contrast, constipation was controlled in only 48% of patients (P>.05). Adherence to the diet was good in 87% of patients and was a predictor of positive response in the univariate analysis.
A diet low in FODMAPs is associated with symptom improvement in patients with IBS and functioanl abdominal bloating. Adherence to the diet was a determining factor.
肠易激综合征(IBS)患者的成功治疗常常难以实现。澳大利亚、英国和新西兰最近的研究表明,低发酵性寡糖、双糖、单糖和多元醇(FODMAPs)饮食在这类患者的管理中具有疗效。本研究的目的是确定低FODMAPs饮食是否能改善西班牙功能性胃肠疾病(FGID)患者的症状,并分析良好反应的预测因素。
对连续性的IBS型FGID和功能性腹胀患者进行了一项前瞻性研究。纳入时,所有患者均通过基线人口统计学问卷对焦虑、抑郁症状及生活质量进行了评估。进行了乳糖和果糖的氢呼气试验,专业营养师为患者指定了为期2个月的低FODMAPs饮食。这些检测作为参考。阳性反应定义为症状问卷中可能的10分中至少改善5分。
我们纳入了30例患者(24名女性,年龄39[12]岁)。低FODMAPs饮食在控制总体症状以及功能性腹胀、腹痛、腹泻、肠胃胀气、恶心和疲劳等特定症状方面,超过70%的患者有阳性反应(P<0.05)。相比之下,只有48%的患者便秘得到控制(P>0.05)。87%的患者对饮食的依从性良好,在单因素分析中,这是阳性反应的一个预测因素。
低FODMAPs饮食与IBS和功能性腹胀患者的症状改善相关。饮食依从性是一个决定性因素。