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低 FODMAP 无麸质饮食改善乳糜泻患者的功能性胃肠疾病和整体心理健康:一项随机对照试验。

A Low FODMAP Gluten-Free Diet Improves Functional Gastrointestinal Disorders and Overall Mental Health of Celiac Disease Patients: A Randomized Controlled Trial.

机构信息

Centre for the Prevention and Diagnosis of Celiac Disease/Division of Gastroenterology and Endoscopy, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.

Department of Biomedical, Surgical and Dental Sciences, University of Milano, 20100 Milan, Italy.

出版信息

Nutrients. 2018 Aug 4;10(8):1023. doi: 10.3390/nu10081023.


DOI:10.3390/nu10081023
PMID:30081576
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6115770/
Abstract

A subset of patients with celiac disease (CD) on a gluten-free diet (GFD) reported the persistence of functional gastrointestinal disorders. Foods containing fermentable, oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) can trigger a broad range of gastrointestinal symptoms in sensitive individuals. We evaluated the effects of a low FODMAP diet (LFD) on gastrointestinal and psychological symptomatology in CD patients. A total of 50 celiac patients on GFDs and with persistence of gastrointestinal symptoms were included. The patients were randomly allocated to one of two dietary groups-one on a low FODMAP GFD (LF-GFD, = 25) and the other on a regular GFD (R-GFD, = 25)-for 21 days. Psychological symptomatology and quality of life were evaluated by the Symptom Checklist-90-R (SCL-90) and the Short Form (36) Health Survey (SF-36) questionnaires, respectively. Gastrointestinal symptomatology and general well-being were evaluated by visual analogue scale (VAS) scores. After 21 days, 21 and 23 patients completed the dietary treatment on LF-GFD and R-GFD, respectively. A reduced global SCL-90 index ( < 0.0003) was found in the LF-GFD group but not in the R-GFD one. However, the SF-36 scores did not differ between groups after treatment. The VAS for abdominal pain was much lower, and the VAS for fecal consistency enhanced after treatment in the LF-GFD group. General well-being increased in both groups but with a much higher improvement in the LF-GFD ( = 0.03). A short-term LFD regimen helps to improve the psychological health and gastrointestinal symptomatology with enhanced well-being of CD patients with persisting functional gastrointestinal symptomatology. The long-term clinical effects of LFD in particular subgroups of CD patients need further evaluation.

摘要

一部分乳糜泻(CD)患者在接受无麸质饮食(GFD)后仍存在功能性胃肠疾病。含有可发酵的、低聚糖、二糖、单糖和多元醇(FODMAP)的食物会在敏感个体中引发广泛的胃肠道症状。我们评估了低 FODMAP 饮食(LFD)对 CD 患者胃肠道和心理症状的影响。共有 50 名接受 GFD 且存在持续性胃肠道症状的乳糜泻患者纳入研究。患者被随机分配到两个饮食组之一:低 FODMAP GFD 组(LF-GFD,n = 25)和常规 GFD 组(R-GFD,n = 25),进行为期 21 天的饮食治疗。心理症状和生活质量分别通过症状清单 90 项-R(SCL-90)和简短健康调查问卷(SF-36)进行评估。胃肠道症状和整体健康状况通过视觉模拟量表(VAS)评分进行评估。21 天后,21 名和 23 名患者分别完成了 LF-GFD 和 R-GFD 的饮食治疗。LF-GFD 组的 SCL-90 总指数降低(<0.0003),而 R-GFD 组没有降低。然而,治疗后两组的 SF-36 评分没有差异。LF-GFD 组的腹痛 VAS 评分明显降低,粪便稠度 VAS 评分改善。两组的整体健康状况均有所改善,但 LF-GFD 组的改善更为明显(=0.03)。短期 LFD 方案有助于改善 CD 患者持续存在功能性胃肠道症状的心理健康和胃肠道症状,提高整体健康状况。LFD 在 CD 患者特定亚组中的长期临床效果需要进一步评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10f6/6115770/9405f3b6eda2/nutrients-10-01023-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10f6/6115770/75ce32d1e020/nutrients-10-01023-g0A1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10f6/6115770/480106f3cc82/nutrients-10-01023-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10f6/6115770/c749b6e9abc5/nutrients-10-01023-g002a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10f6/6115770/9405f3b6eda2/nutrients-10-01023-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10f6/6115770/75ce32d1e020/nutrients-10-01023-g0A1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10f6/6115770/480106f3cc82/nutrients-10-01023-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10f6/6115770/c749b6e9abc5/nutrients-10-01023-g002a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10f6/6115770/9405f3b6eda2/nutrients-10-01023-g003.jpg

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本文引用的文献

[1]
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Nutrition. 2017-7-13

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Curr Gastroenterol Rep. 2017-9-8

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World J Gastroenterol. 2017-5-14

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Eur J Nutr. 2017-3

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FODMAPs alter symptoms and the metabolome of patients with IBS: a randomised controlled trial.

Gut. 2016-3-14

[10]
Evidence for the Presence of Non-Celiac Gluten Sensitivity in Patients with Functional Gastrointestinal Symptoms: Results from a Multicenter Randomized Double-Blind Placebo-Controlled Gluten Challenge.

Nutrients. 2016-2-8

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