Ahmad O F, Akbar A
Department of Gastroenterology, Whittington Hospital, Magdala Avenue, London N19 5NF, UK.
Department of Gastroenterology, St Mark's Hospital, Watford Road, Harrow, Middlesex HA1 3UJ, UK
Br Med Bull. 2015 Mar;113(1):83-90. doi: 10.1093/bmb/ldu039. Epub 2015 Jan 19.
Food is a recognized trigger for most patients with irritable bowel syndrome (IBS). In recent years, an emerging evidence base has identified dietary manipulation as an important therapeutic approach in IBS.
Original and review articles were identified through selective searches performed on PubMed and Google Scholar.
Randomized controlled trials have supported the use of a diet that restricts a group of short-chain carbohydrates known collectively as fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs). There is evidence that specific probiotics may improve symptoms in IBS.
The role of a high-fibre diet remains subject to ongoing debate with a lack of high-quality evidence. The long-term durability and safety of a low FODMAP diet are unclear.
A paradigm shift has led to a focus on the relationship between diet and pathophysiological mechanisms in IBS such as effects on intestinal microbiota, inflammation, motility, permeability and visceral hypersensitivity.
Future large, randomized controlled trials with rigorous end points are required. In addition, predictors of response need to be identified to offer personalized therapy.
食物是大多数肠易激综合征（IBS）患者公认的触发因素。近年来，新出现的证据表明饮食调整是IBS的一种重要治疗方法。
通过在PubMed和谷歌学术上进行的选择性检索确定了原始文章和综述文章。
随机对照试验支持采用限制一组统称为可发酵寡糖、双糖、单糖和多元醇（FODMAPs）的短链碳水化合物的饮食。有证据表明特定的益生菌可能改善IBS的症状。
高纤维饮食的作用仍存在争议，缺乏高质量证据。低FODMAP饮食的长期持久性和安全性尚不清楚。
范式转变导致人们关注饮食与IBS病理生理机制之间的关系，如对肠道微生物群、炎症、动力、通透性和内脏超敏反应的影响。
未来需要进行有严格终点的大型随机对照试验。此外，需要确定反应的预测因素以提供个性化治疗。
