Division of Gastroenterology, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand.
Center of Excellence on Neurogastroenterology and Motility, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
Nutrients. 2019 Nov 21;11(12):2856. doi: 10.3390/nu11122856.
A low fermentable oligosaccharide, disaccharide, monosaccharide, and polyol (FODMAP) diet has been recommended for irritable bowel syndrome (IBS) patients. This study compared the efficacy of two types of dietary advice: (1) brief advice on a commonly recommended diet (BRD), and (2) structural individual low-FODMAP dietary advice (SILFD). Patients with moderate-to-severe IBS were randomized to BRD or SILFD groups. Gastrointestinal symptoms, 7-day food diaries, and post-prandial breath samples were evaluated. The SILFD included (1) identifying high-FODMAP items from the diary, (2) replacing high-FODMAP items with low-FODMAP ones by choosing from the provided menu. The BRD included reducing traditionally recognized foods that cause bloating/abdominal pain and avoidance of large meals. Responders were defined as those experiencing a ≥30% decrease in the average of daily worst abdominal pain/discomfort after 4 weeks. Sixty-two patients (47 F, age 51 ± 14 years), BRD ( = 32) or SILFD ( = 30), completed the studies. Eighteen (60%) patients in SILFD vs. 9 (28%) in the BRD group fulfilled responder criteria ( = 0.001). Global IBS symptom severity significantly improved and the number of high-FODMAP items consumed was significantly decreased after SILFD compared to BRD. Post-prandial hydrogen (H) breath production after SILFD was significantly lower than was seen after BRD ( < 0.001). SILFD was more effective than BRD. This advice method significantly reduced FODMAP intake, improved IBS symptoms, and lowered intestinal H production.
低发酵可利用的寡糖、双糖、单糖和多元醇（FODMAP）饮食已被推荐用于肠易激综合征（IBS）患者。本研究比较了两种饮食建议的疗效：（1） 对常用推荐饮食的简要建议（BRD），和（2） 结构个体化低 FODMAP 饮食建议（SILFD）。中度至重度 IBS 患者被随机分配到 BRD 或 SILFD 组。评估胃肠道症状、7 天食物日记和餐后呼吸样本。SILFD 包括（1）从日记中识别高 FODMAP 项目，（2）通过从提供的菜单中选择，用低 FODMAP 项目替换高 FODMAP 项目。BRD 包括减少传统上被认为会引起腹胀/腹痛的食物，并避免大餐。应答者定义为在 4 周后平均每日最严重腹痛/不适减少≥30%的患者。62 名患者（47 名女性，年龄 51 ± 14 岁），BRD（ = 32）或 SILFD（ = 30）完成了研究。在 SILFD 组中有 18 名（60%）患者符合应答标准，而在 BRD 组中仅有 9 名（28%）（ = 0.001）。与 BRD 相比，SILFD 后全球 IBS 症状严重程度显著改善，且消耗的高 FODMAP 项目数量显著减少。与 BRD 相比，SILFD 后餐后氢气（H）呼吸产生明显降低（ < 0.001）。SILFD 比 BRD 更有效。这种建议方法显著减少了 FODMAP 摄入，改善了 IBS 症状，并降低了肠道 H 产生。
