Wei H, Liu Z J, Wang K, Zheng W, Duan L P
Department of Gastroenterology, Peking University Third Hospital, Beijing 100191, China.
Zhonghua Nei Ke Za Zhi. 2017 Aug 1;56(8):567-571. doi: 10.3760/cma.j.issn.0578-1426.2017.08.003.
To explore the diet features of diarrhea predominant irritable bowel syndrome (IBS-D) with small intestinal bacterial overgrowth (SIBO). IBS-D patients were enrolled in outpatient department of Peking University Third Hospital from March 2015 to April 2016. Healthy volunteers were recruited as controls (HC). All the subjects completed screening examinations, clinical and food investigation, and lactulose methane and hydrogen breath test (LMHBT). The high fat diet is defined as the daily total calories supplying from fat is more than 50%. Eighty-eight IBS-D patients and 32 HC were finally enrolled. The positive rate of LMHBT in IBS-D was significantly higher than that of HC[39.8% (35/88) vs 12.5%(4/28), =0.005]. The 28 HC with negative LMHBT were enrolled in the follow-up analysis. (1) The BMI of IBS-P (IBS-D with positive LMHBT) was significantly lower than IBS-N (IBS-D with negative LMHBT) [(21.57±0.54) vs (23.30±0.53)kg/m(2,) =0.032]. IBS-D patients with SIBO had higher scores of abdominal pain assess. (2) The proportion of dietary protein and carbohydrate in IBS-D was significantly higher than that of HC (14.39% vs 12.22%, =0.001; 53.94% vs 46.25%, =0.003, respectively). The proportion of diet fat was significantly higher in IBS-P than IBS-N[(47.19±2.62)% vs (40.74±1.66)%, =0.038]. (3) The baseline of breath methane in IBS-P was significantly higher than that of in IBS-N[(8.69±0.39) ×10(-6) vs (6.39±0.47) ×10(-6,) =0.002]. IBS-D patients with high fat diet had higher LMHBT positive rate than that of non-high fat diet patients[54.2% (13/24) vs 17.2% (11/64), =0.001]. Breath methane peak value was positively correlated with the fat proportion of diet (=0.413, =0.022). About 39.8% IBS-D patients diagnosed by Rome Ⅲ are combined with SIBO. SIBO may affect IBS-D patients' nutritional status. High fat diet might be one of the risk factors for IBS-D with SIBO. Proper diet structure might reduce the prevalence of IBS-D, especially for IBS-D with SIBO.
探讨合并小肠细菌过度生长（SIBO）的腹泻型肠易激综合征（IBS-D）的饮食特点。2015年3月至2016年4月，北京大学第三医院门诊招募IBS-D患者。招募健康志愿者作为对照（HC）。所有受试者均完成筛查检查、临床及饮食调查，以及乳果糖甲烷和氢气呼气试验（LMHBT）。高脂肪饮食定义为每日脂肪提供的总热量超过50%。最终纳入88例IBS-D患者和32例HC。IBS-D患者中LMHBT阳性率显著高于HC[39.8%（35/88）对12.5%（4/28），P = 0.005]。将28例LMHBT阴性的HC纳入随访分析。（1）IBS-P组（LMHBT阳性的IBS-D患者）的BMI显著低于IBS-N组（LMHBT阴性的IBS-D患者）[（21.57±0.54）对（23.30±0.53）kg/m²，P = 0.032]。合并SIBO的IBS-D患者腹痛评分更高。（2）IBS-D患者饮食中蛋白质和碳水化合物的比例显著高于HC（分别为14.39%对12.22%，P = 0.001；53.94%对46.25%，P = 0.003）。IBS-P组饮食脂肪比例显著高于IBS-N组[（47.19±2.62）%对（40.74±1.66）%，P = 0.038]。（3）IBS-P组呼气甲烷基线显著高于IBS-N组[（8.69±0.39）×10⁻⁶对（6.39±0.47）×10⁻⁶，P = 0.002]。高脂肪饮食的IBS-D患者LMHBT阳性率高于非高脂肪饮食患者[54.2%（13/24）对17.2%（11/64），P = 0.001]。呼气甲烷峰值与饮食脂肪比例呈正相关（r = 0.413，P = （此处原文有误，推测应为P = 0.022））。约39.8%符合罗马Ⅲ标准的IBS-D患者合并SIBO。SIBO可能影响IBS-D患者的营养状况。高脂肪饮食可能是合并SIBO的IBS-D的危险因素之一。合理的饮食结构可能降低IBS-D的患病率，尤其是合并SIBO的IBS-D。
