Pedersen Natalia, Ankersen Dorit Vedel, Felding Maria, Wachmann Henrik, Végh Zsuzsanna, Molzen Line, Burisch Johan, Andersen Jens Rikardt, Munkholm Pia
Natalia Pedersen, Department of Gastroenterology, Slagelse Hospital, 4200 Slagelse, Denmark.
World J Gastroenterol. 2017 May 14;23(18):3356-3366. doi: 10.3748/wjg.v23.i18.3356.
To investigate the effect of a low-FODMAP diet on irritable bowel syndrome (IBS)-like symptoms in patients with inflammatory bowel disease (IBD).
This was a randomised controlled open-label trial of patients with IBD in remission or with mild-to-moderate disease and coexisting IBS-like symptoms (Rome III) randomly assigned to a Low-FODMAP diet (LFD) or a normal diet (ND) for 6 wk between June 2012 and December 2013. Patients completed the IBS symptom severity system (IBS-SSS) and short IBD quality of life questionnaire (SIBDQ) at weeks 0 and 6. The primary end-point was response rates (at least 50-point reduction) in IBS-SSS at week 6 between groups; secondary end-point was the impact on quality of life.
Eighty-nine patients, 67 (75%) women, median age 40, range 20-70 years were randomised: 44 to LFD group and 45 to ND, from which 78 patients completed the study period and were included in the final analysis (37 LFD and 41 ND). There was a significantly larger proportion of responders in the LFD group ( = 30, 81%) than in the ND group ( = 19, 46%); (OR = 5.30; 95%CI: 1.81-15.55, < 0.01). At week 6, the LFD group showed a significantly lower median IBS-SSS (median 115; inter-quartile range [IQR] 33-169) than ND group (median 170, IQR 91-288), = 0.02. Furthermore, the LFD group had a significantly greater increase in SIBDQ (median 60, IQR 51-65) than the ND group (median 50, IQR 39-60), < 0.01.
In a prospective study, a low-FODMAP diet reduced IBS-like symptoms and increased quality of life in patients with IBD in remission.
探讨低发酵性寡糖、双糖、单糖和多元醇（FODMAP）饮食对炎症性肠病（IBD）患者肠易激综合征（IBS）样症状的影响。
这是一项随机对照开放标签试验，研究对象为病情缓解或轻度至中度的IBD患者且伴有IBS样症状（罗马III标准），于2012年6月至2013年12月期间随机分为低FODMAP饮食（LFD）组或正常饮食（ND）组，为期6周。患者在第0周和第6周完成IBS症状严重程度系统（IBS-SSS）和简短IBD生活质量问卷（SIBDQ）。主要终点是两组在第6周时IBS-SSS的缓解率（至少降低50分）；次要终点是对生活质量的影响。
89例患者，67例（75%）为女性，中位年龄40岁，年龄范围20 - 70岁，被随机分组：44例进入LFD组，45例进入ND组，其中78例患者完成研究期并纳入最终分析（37例LFD组和41例ND组）。LFD组缓解者比例（n = 30，81%）显著高于ND组（n = 19，46%）；（优势比[OR] = 5.30；95%置信区间[CI]：1.81 - 15.55，P < 0.01）。在第6周时，LFD组的IBS-SSS中位数（中位数115；四分位间距[IQR] 33 - 169）显著低于ND组（中位数170，IQR 91 - 288），P = 0.02。此外，LFD组的SIBDQ增加幅度（中位数60，IQR 51 - 65）显著大于ND组（中位数50，IQR 39 - 60），P < 0.01。
在一项前瞻性研究中，低FODMAP饮食可减轻病情缓解的IBD患者的IBS样症状并提高生活质量。
