Division of Gastroenterology, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan, USA.
Clin Transl Gastroenterol. 2019 Jul;10(7):e00060. doi: 10.14309/ctg.0000000000000060.
Fecal incontinence (FI) is a common complaint and is often associated with diarrhea and urgency. Foods high in fermentable oligo-, di-, and mono-saccharides and polyols (FODMAP) cause symptoms of diarrhea and urgency. Therefore, this study assesses the impact of a low FODMAP diet on the occurrence of FI due to loose stool.
This study is a retrospective chart review of patients with FI seen in the Michigan Bowel Control Program clinic between August 2012 and December 2017. Patients who had FI with loose stool without red flag signs and who were recommended a low FODMAP diet and underwent formal dietary instruction with a Michigan Medicine dietician were included.
Sixty-five patients with FI who underwent formal dietary teaching were included in this study. Eighty-eight percent of the patients were white, and 87% were women with a mean age of 62 years (±14 years). Additionally, the chart review showed that 35% of the patients had FI daily, 21.5% had FI weekly, and 5% had FI monthly. About 64.6% of the patients (42) had reported a reduction in their FI symptoms with the low FODMAP diet. There was no demographic or clinical characteristic that predicted the response to a low FODMAP diet.
In this case series, dietary manipulation with a low FODMAP diet was a useful tool to treat patients who suffer from FI due to loose stool. Further confirmatory, prospective randomized controlled trials are required to see the true efficacy of a low FODMAP diet in patients who suffer with FI.
粪便失禁（FI）是一种常见的主诉，常与腹泻和急迫感相关。富含可发酵寡糖、双糖、单糖和多元醇（FODMAP）的食物可引起腹泻和急迫感的症状。因此，本研究评估了低 FODMAP 饮食对稀便所致 FI 发生的影响。
这是一项对 2012 年 8 月至 2017 年 12 月期间在密歇根肠控项目诊所就诊的 FI 患者的回顾性图表审查研究。纳入 FI 伴稀便且无红色警示征象的患者，并建议他们采用低 FODMAP 饮食，并由密歇根医学营养师进行正式饮食指导。
本研究纳入了 65 例接受正式饮食教学的 FI 患者。88%的患者为白人，87%为女性，平均年龄为 62 岁（±14 岁）。此外，图表回顾显示，35%的患者每天有 FI，21.5%的患者每周有 FI，5%的患者每月有 FI。约 64.6%的患者（42 例）报告低 FODMAP 饮食可减轻 FI 症状。没有任何人口统计学或临床特征可预测低 FODMAP 饮食的反应。
在本病例系列中，低 FODMAP 饮食的饮食干预是治疗因稀便而遭受 FI 困扰的患者的有用工具。需要进一步进行确证性、前瞻性随机对照试验，以了解低 FODMAP 饮食对 FI 患者的真实疗效。
