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饮食干预与肠易激综合征:证据综述

Dietary Interventions and Irritable Bowel Syndrome: A Review of the Evidence.

作者信息

Shah Shawn L, Lacy Brian E

机构信息

Division of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA.

出版信息

Curr Gastroenterol Rep. 2016 Aug;18(8):41. doi: 10.1007/s11894-016-0517-x.

DOI:10.1007/s11894-016-0517-x
PMID:27372289
Abstract

Irritable bowel syndrome (IBS) is the best studied of the functional gastrointestinal disorders. It is a highly prevalent disorder characterized by symptoms of abdominal pain, bloating, and disordered bowel habits, which may include constipation, diarrhea, or both. IBS has a significant negative impact on patients, both financially and with regard to their quality-of-life. At present, there is no cure for IBS, and while there are a number of pharmacological therapies available to treat IBS symptoms, they are not uniformly effective. For this reason, many patients and providers are turning to dietary interventions in an attempt to ameliorate IBS symptoms. At first glance, this approach appears reasonable as dietary interventions are generally safe and side effects, including potential adverse reactions with medications, are rare. However, although dietary interventions for IBS are frequently recommended, there is a paucity of data to support their use. The goals of this article are to answer key questions about diets currently recommended for the treatment of IBS, using the best available data from the literature.

摘要

肠易激综合征(IBS)是功能性胃肠疾病中研究最多的疾病。它是一种高度常见的疾病,其特征为腹痛、腹胀以及排便习惯紊乱,这可能包括便秘、腹泻或两者兼有。IBS对患者在经济和生活质量方面都有重大负面影响。目前,IBS无法治愈,虽然有多种药物疗法可用于治疗IBS症状,但它们并非都有效。因此,许多患者和医疗服务提供者正在转向饮食干预措施,试图改善IBS症状。乍一看,这种方法似乎合理,因为饮食干预措施通常是安全的,而且副作用很少,包括与药物的潜在不良反应。然而,尽管经常推荐对IBS进行饮食干预,但支持其使用的数据却很少。本文的目的是利用文献中现有的最佳数据,回答有关目前推荐用于治疗IBS的饮食的关键问题。

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本文引用的文献

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Efficacy of a Gluten-Free Diet in Subjects With Irritable Bowel Syndrome-Diarrhea Unaware of Their HLA-DQ2/8 Genotype.无麸质饮食对 HILA-DQ2/8 基因型未知的腹泻型肠易激综合征患者的疗效。
Clin Gastroenterol Hepatol. 2016 May;14(5):696-703.e1. doi: 10.1016/j.cgh.2015.12.031. Epub 2015 Dec 31.
2
The Effect of Dietary Intervention on Irritable Bowel Syndrome: A Systematic Review.饮食干预对肠易激综合征的影响:一项系统评价
Clin Transl Gastroenterol. 2015 Aug 20;6(8):e107. doi: 10.1038/ctg.2015.21.
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American Gastroenterological Association Institute Technical Review on the pharmacological management of irritable bowel syndrome.
增强面包的益处:探究强化天然酸面团对小麦面包中FODMAP调节及抗氧化潜力的影响。
Foods. 2023 Sep 24;12(19):3552. doi: 10.3390/foods12193552.
4
Effect of Inoculated Lactic Acid Fermentation on the Fermentable Saccharides and Polyols, Polyphenols and Antioxidant Activity Changes in Wheat Sourdough.接种发酵对小麦发酵面团中可发酵糖和多元醇、多酚和抗氧化活性变化的影响。
Molecules. 2021 Jul 10;26(14):4193. doi: 10.3390/molecules26144193.
5
Effect of Three Diets (Low-FODMAP, Gluten-free and Balanced) on Irritable Bowel Syndrome Symptoms and Health-Related Quality of Life.三种饮食(低 FODMAP、无麸质和均衡)对肠易激综合征症状和健康相关生活质量的影响。
Nutrients. 2019 Jul 11;11(7):1566. doi: 10.3390/nu11071566.
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Rome Criteria and a Diagnostic Approach to Irritable Bowel Syndrome.罗马标准与肠易激综合征的诊断方法
J Clin Med. 2017 Oct 26;6(11):99. doi: 10.3390/jcm6110099.
7
Dietary fiber in irritable bowel syndrome (Review).肠易激综合征中的膳食纤维(综述)
Int J Mol Med. 2017 Sep;40(3):607-613. doi: 10.3892/ijmm.2017.3072. Epub 2017 Jul 19.
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World J Gastroenterol. 2017 Jun 14;23(22):4112-4120. doi: 10.3748/wjg.v23.i22.4112.
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Gastroenterology. 2014 Nov;147(5):1149-72.e2. doi: 10.1053/j.gastro.2014.09.002. Epub 2014 Sep 16.
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American College of Gastroenterology monograph on the management of irritable bowel syndrome and chronic idiopathic constipation.美国胃肠病学会关于肠易激综合征和慢性特发性便秘管理的专著。
Am J Gastroenterol. 2014 Aug;109 Suppl 1:S2-26; quiz S27. doi: 10.1038/ajg.2014.187.
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The effect of fiber supplementation on irritable bowel syndrome: a systematic review and meta-analysis.膳食纤维补充剂对肠易激综合征的影响:系统评价和荟萃分析。
Am J Gastroenterol. 2014 Sep;109(9):1367-74. doi: 10.1038/ajg.2014.195. Epub 2014 Jul 29.
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Nutr Clin Pract. 2014 Aug;29(4):504-509. doi: 10.1177/0884533614529163. Epub 2014 Apr 16.
7
A diet low in FODMAPs reduces symptoms of irritable bowel syndrome.低 FODMAP 饮食可减轻肠易激综合征症状。
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8
The low FODMAP diet improves gastrointestinal symptoms in patients with irritable bowel syndrome: a prospective study.低 FODMAP 饮食可改善肠易激综合征患者的胃肠道症状:一项前瞻性研究。
Int J Clin Pract. 2013 Sep;67(9):895-903. doi: 10.1111/ijcp.12128. Epub 2013 May 23.
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No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates.在减少可发酵、不易吸收、短链碳水化合物的饮食后,自述非乳糜泻麸质敏感性的患者中无麸质的影响。
Gastroenterology. 2013 Aug;145(2):320-8.e1-3. doi: 10.1053/j.gastro.2013.04.051. Epub 2013 May 4.
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Self-reported food-related gastrointestinal symptoms in IBS are common and associated with more severe symptoms and reduced quality of life.肠易激综合征患者常自述与食物相关的胃肠道症状,且这些症状与更严重的症状和更低的生活质量相关。
Am J Gastroenterol. 2013 May;108(5):634-41. doi: 10.1038/ajg.2013.105.