Brown Stephanie C, Whelan Kevin, Gearry Richard B, Day Andrew S
Department of Paediatrics University of Otago Christchurch Christchurch New Zealand.
Department of Nutritional Sciences Kings College London London UK.
JGH Open. 2019 Aug 2;4(2):153-159. doi: 10.1002/jgh3.12231. eCollection 2020 Apr.
Functional bowel disorders (FBD), such as irritable bowel syndrome (IBS), are increasingly more common in children and affect up to 20% of children. The etiology is multifactorial with no clear organic cause. Symptoms are recurrent and are associated with a reduced quality of life, school absences, and psychological challenges. Treatment options are variable. FODMAPs are short-chained carbohydrates, poorly absorbed by the gastrointestinal tract due to their increased osmotic activity and excess gas production from the bacterial fermentation process. There is a paucity of data examining dietary interventions that restrict carbohydrates in children with IBS. The aim of this study was to examine the use of the low FODMAP diet (LFD) in children with an FBD.
A retrospective clinical case note review of children with an FBD managed with an LFD was undertaken. Anthropometry and clinical data were collected by a pediatric gastroenterology dietitian. An IBS satisfaction survey was used to assess diet outcomes. Statistical analyses were completed using Excel.
Of the 29 children included in this study, complete resolution of gastrointestinal symptoms was observed for 11 of 12 (92%) of those with bloating, 13 of 15 (87%) of those with diarrhea, and 17 of 22 (77%) of those with abdominal pain. Twenty-three (79%) participants reported an improvement of symptoms. Fructans were the most common symptom-causing carbohydrate.
The LFD is a useful dietary treatment strategy for children with FBD. This study adds to the small body of evidence supporting FODMAP dietary interventions in children with FBD. Further prospective studies are required.
功能性肠病（FBD），如肠易激综合征（IBS），在儿童中越来越常见，影响多达20%的儿童。其病因是多因素的，没有明确的器质性病因。症状反复出现，与生活质量下降、缺课和心理挑战有关。治疗选择多种多样。FODMAPs是短链碳水化合物，由于其渗透活性增加和细菌发酵过程中产生过多气体，胃肠道对其吸收不良。关于限制IBS儿童碳水化合物摄入的饮食干预研究数据很少。本研究的目的是探讨低FODMAP饮食（LFD）在FBD儿童中的应用。
对采用LFD治疗的FBD儿童进行回顾性临床病例记录回顾。人体测量和临床数据由儿科胃肠病学营养师收集。使用IBS满意度调查来评估饮食结果。使用Excel完成统计分析。
在本研究纳入的29名儿童中，12名腹胀儿童中有11名（92%）、15名腹泻儿童中有13名（87%）、22名腹痛儿童中有17名（77%）的胃肠道症状完全缓解。23名（79%）参与者报告症状有所改善。果聚糖是最常见的引起症状的碳水化合物。
LFD是FBD儿童有用的饮食治疗策略。本研究为支持FODMAP饮食干预FBD儿童的少量证据增添了内容。需要进一步的前瞻性研究。
