Jung Kee Wook, Seo Myeognsook, Cho Young Hwan, Park Young-Ok, Yoon So-Yoon, Lee Jungbok, Yang Dong-Hoon, Yoon In Ja, Seo So Young, Lee Hyo Jeong, Park Sang Hyoung, Kim Kyung Jo, Ye Byong Duk, Byeon Jeong-Sik, Jung Hwoon-Yong, Yang Suk-Kyun, Kim Jin-Ho, Myung Seung-Jae
Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Clinical Nutrition, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
J Neurogastroenterol Motil. 2018 Apr 30;24(2):307-316. doi: 10.5056/jnm17044.
BACKGROUND/AIMS: Fructose malabsorption (FM) mimics symptoms of irritable bowel syndrome (IBS), and its prevalence has increased. Diagnosing FM in IBS is challenging because of its overlap with small intestinal bacterial overgrowth (SIBO). We assessed the prevalence of FM by comparing patients with IBS with asymptomatic control individuals after excluding SIBO using the glucose hydrogen breath test (HBT).
Patients diagnosed with IBS and asymptomatic control individuals were enrolled prospectively. Dietary habits were assessed with the Food Frequency Questionnaire. After excluding SIBO, participants underwent HBTs with both 15 g and 25 g of fructose.
Thirty-five patients with IBS and 35 age- and sex-matched asymptomatic control individuals were enrolled. The 15-g fructose HBT yielded positive results in 7 of the 35 (20.0%) patients with IBS and in 2 of 35 (5.7%) controls ( = 0.070). The 25-g fructose HBT was positive in 16 of the 35 (45.7%) patients with IBS and in 8 of the 35 (22.9%) controls ( = 0.040). Analysis of the Food Frequency Questionnaire responses showed no significant differences between the 2 groups in dietary intake, although patients with IBS showed a significantly higher mean fiber intake than controls (21.24 ± 11.35 g vs 15.87 ± 7.07 g, respectively, = 0.040).
The 25-g fructose HBT identified FM in a significantly higher percentage of SIBO-negative patients with IBS than in asymptomatic control individuals, suggesting that FM may correlate with IBS. Education regarding dietary control of foods containing fructose may be useful for the management of patients with IBS.
背景/目的：果糖吸收不良（FM）的症状与肠易激综合征（IBS）相似，且其患病率呈上升趋势。由于FM与小肠细菌过度生长（SIBO）存在重叠，因此在IBS患者中诊断FM具有挑战性。我们通过使用葡萄糖氢呼气试验（HBT）排除SIBO后，比较IBS患者与无症状对照个体，评估FM的患病率。
前瞻性纳入诊断为IBS的患者和无症状对照个体。通过食物频率问卷评估饮食习惯。排除SIBO后，参与者接受15克和25克果糖的HBT检测。
纳入35例IBS患者和35例年龄及性别匹配的无症状对照个体。15克果糖HBT检测中，35例IBS患者中有7例（20.0%）结果为阳性，35例对照中有2例（5.7%）结果为阳性（P = 0.070）。25克果糖HBT检测中，35例IBS患者中有16例（45.7%）结果为阳性，35例对照中有8例（22.9%）结果为阳性（P = 0.040）。对食物频率问卷回答的分析显示，两组在饮食摄入量方面无显著差异，尽管IBS患者的平均纤维摄入量显著高于对照组（分别为21.24±11.35克和15.87±7.07克，P = 0.040）。
25克果糖HBT检测出SIBO阴性的IBS患者中FM的比例显著高于无症状对照个体，提示FM可能与IBS相关。关于含果糖食物饮食控制的教育可能对IBS患者的管理有用。
