Department of Life, Health and Environmental Sciences, Epidemiology and Biostatistics Unit, University of L'Aquila, 67100 L'Aquila, Italy.
Department of Life, Health and Environmental Sciences, Gastroenterology Unit, University of L'Aquila, 67100 L'Aquila, Italy.
Nutrients. 2017 Aug 26;9(9):940. doi: 10.3390/nu9090940.
Irritable bowel syndrome (IBS) affects 7-15% of the general population. A recently devised dietary approach consists of restricting foods with highly fermentable oligo-, di-, and monosaccharides, and polyols (FODMAPs), which can trigger and/or exacerbate IBS symptoms. The aim of this study is to use meta-analysis to provide an update on the randomised control trials (RCTs) and cohort studies, and examine them separately in relation to diet type. Papers were selected using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart. Cohen's and odds ratios were used as a measure of effect size for RCTs. A random effects model was used to account for different sources of variation among studies. Heterogeneity was assessed using Q statistics, ², Tau, and Tau². Publication bias was analysed and represented by a funnel plot, and funnel plot symmetry was assessed with Egger's test. The results showed that in the RCTs, the patients receiving a low-FODMAP diet experienced a statistically significant pain and bloating reduction compared with those receiving a traditional diet; as regards to stool consistency, there was no significant difference between treatments. A significant reduction in abdominal pain and bloating were described by patients receiving a low-FODMAP diet compared with those receiving a high-FODMAP diet. In cohort studies, pain and bloating were significantly reduced after treatment compared with the baseline diet. We conclude that there is evidence that a low-FODMAP diet could have a favourable impact on IBS symptoms, especially abdominal pain and bloating. However, it remains to be demonstrated whether a low-FODMAP diet is superior to conventional IBS diets, especially in the long term.
肠易激综合征（IBS）影响 7-15%的普通人群。最近提出的一种饮食方法包括限制高可发酵寡糖、二糖和单糖以及多元醇（FODMAPs）的食物，这些食物会引发和/或加重 IBS 症状。本研究的目的是使用荟萃分析提供随机对照试验（RCT）和队列研究的最新信息，并分别根据饮食类型对其进行检查。使用系统评价和荟萃分析的首选报告项目（PRISMA）流程图选择论文。使用 Cohen's 和优势比作为 RCT 的效应量测量。使用随机效应模型来解释研究之间不同来源的变异。使用 Q 统计量、²、Tau 和 Tau²评估异质性。分析了发表偏倚并通过漏斗图表示，并使用 Egger 检验评估漏斗图的对称性。结果表明，在 RCT 中，与接受传统饮食的患者相比，接受低 FODMAP 饮食的患者疼痛和腹胀明显减轻；关于粪便稠度，两种治疗方法之间没有显著差异。与接受高 FODMAP 饮食的患者相比，接受低 FODMAP 饮食的患者腹痛和腹胀明显减轻。在队列研究中，与基线饮食相比，治疗后疼痛和腹胀明显减轻。我们得出的结论是，有证据表明低 FODMAP 饮食可能对 IBS 症状有有利影响，尤其是腹痛和腹胀。然而，低 FODMAP 饮食是否优于传统的 IBS 饮食，特别是在长期方面，仍有待证明。
