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超越肠易激综合征:低发酵性寡糖、双糖、单糖和多元醇饮食对改善炎症性肠病和乳糜泻症状的疗效

Beyond Irritable Bowel Syndrome: The Efficacy of the Low Fodmap Diet for Improving Symptoms in Inflammatory Bowel Diseases and Celiac Disease.

作者信息

Testa Anna, Imperatore Nicola, Rispo Antonio, Rea Matilde, Tortora Raffaella, Nardone Olga Maria, Lucci Lucia, Accarino Grazia, Caporaso Nicola, Castiglione Fabiana

机构信息

Gastroenterology, Department of Clinical Medicine and Surgery, School of Medicine "Federico II" University of Naples, Naples, Italy.

Nutrition, Department of Clinical Medicine and Surgery, School of Medicine "Federico II" University of Naples, Naples, Italy.

出版信息

Dig Dis. 2018;36(4):271-280. doi: 10.1159/000489487. Epub 2018 May 15.

Abstract

BACKGROUND AND AIM

To evaluate the usefulness of a low FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) diet on patients with irritable bowel syndrome (IBS), non-active inflammatory bowel diseases (IBD), and celiac disease (CD) on a gluten-free diet (GFD).

METHODS

Dietetic interventional prospective study. IBS, IBD, and CD subjects were evaluated to check if they fulfilled the Rome III criteria. Each subject was educated to follow a low FODMAP diet after being evaluated by filling out questionnaires that assessed the quality of life (QoL) and symptoms experienced (IBS-SSS and SF-36), and was reevaluated after 1 and 3 months.

RESULTS

One hundred twenty-seven subjects were enrolled: 56 with IBS, 30 with IBD, and 41 with CD. IBS-SSS showed that abdominal symptoms improved after 1 and 3 months of diet in all subjects, with significant difference among the 3 groups at T0 (average scores IBS: 293 ± 137, IBD: 206 ± 86, CD: 222 ± 65, p < 0.001), but no difference at T3 (IBS: 88 ± 54, IBD: 73 ± 45, CD: 77 ± 49, p = ns). By analyzing the SF-36 questionnaire, we did not observe any difference between the 3 groups, in terms of response to diet (p = ns), we observed a clinical improvement from T0 to T3 for most of the questionnaire's domains.

CONCLUSIONS

A low FODMAP diet could be a valid option to counter -abdominal symptoms in patients with IBS, non-active IBD, or CD on a GFD, and thus, improve their QoL and social -relations.

摘要

背景与目的

评估低发酵性寡糖、双糖、单糖和多元醇(FODMAP)饮食对肠易激综合征(IBS)、非活动性炎症性肠病(IBD)以及采用无麸质饮食(GFD)的乳糜泻(CD)患者的有效性。

方法

饮食干预前瞻性研究。对IBS、IBD和CD患者进行评估,以检查他们是否符合罗马III标准。在通过填写评估生活质量(QoL)和所经历症状(IBS-SSS和SF-36)的问卷进行评估后,每位受试者都接受了遵循低FODMAP饮食的指导,并在1个月和3个月后进行重新评估。

结果

共纳入127名受试者:56例IBS患者,30例IBD患者,41例CD患者。IBS-SSS显示,所有受试者在饮食1个月和3个月后腹部症状均有所改善,在T0时三组之间存在显著差异(平均得分IBS:293±137,IBD:206±86,CD:222±65,p<0.001),但在T3时无差异(IBS:88±54,IBD:73±45,CD:77±49,p=无统计学意义)。通过分析SF-36问卷,我们未观察到三组在饮食反应方面存在任何差异(p=无统计学意义),我们观察到大多数问卷领域从T0到T3有临床改善。

结论

低FODMAP饮食可能是改善IBS、非活动性IBD或采用GFD的CD患者腹部症状的有效选择,从而改善他们的生活质量和社会关系。

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