Cheng Peng, Ma Ruijun, Wang Shuling, Fang Jun, Zhong Zhengrong, Bai Yu, Meng Xiangjun, Li Zhaoshen
Department of Gastroenterology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Center for Gastrointestinal Endoscopy, Shanxi Provincial People's Hospital, Taiyuan, China.
Gastroenterol Res Pract. 2020 Jun 22;2020:1612040. doi: 10.1155/2020/1612040. eCollection 2020.
Optimal bowel preparation for colonoscopy is fundamental to a successful examination. The FODMAP diet can increase the content of intestinal water and gas, but its impact on bowel cleanliness and bubbles has not been reported. This study was therefore aimed at evaluating the effect of the FODMAP diet on the quality of bowel preparation and the adenoma detection rate (ADR).
This was a multicenter, prospective cohort study involving consecutive patients who underwent colonoscopy in two centers in China. Patients were assigned to one of two groups: high-FODMAP or nonhigh-FODMAP diet. ODMP Software was used for the identification of FODMAP diet types. The primary outcome was ADR; secondary outcomes were the quality of bowel preparation, measured by the Boston bowel preparation scale and bubble scores.
There were 365 patients included. Patients in the high-FODMAP-diet group showed poor bowel cleansing efficacy: BBPS ≥ 6 in 76.8% vs. 90.3% ( < 0.01) and bubble scores of 2.42 ± 1.69 vs. 1.32 ± 1.63 ( < 0.001). The intubation time was significantly longer in the high-FODMAP-diet group (7.07 ± 5.18 vs. 5.46 ± 3.05 min; = 0.002). The High-FODMAP diet was an independent risk predictor for inadequate bowel preparation. There were no statistically significant differences in ADR between the two dietary groups.
The high-FODMAP diet significantly reduced the quality of bowel preparation. We recommend the consumption of nonhigh-FODMAP diet in bowel preparation as a reference standard for dietary regimen. This method was effective, flexible, referable, and well tolerated, which could help to provide patients a valuable dietary guidance in bowel preparation.
结肠镜检查的最佳肠道准备是检查成功的基础。可发酵的寡糖、双糖、单糖和多元醇（FODMAP）饮食可增加肠道水和气体含量，但其对肠道清洁度和气泡的影响尚未见报道。因此，本研究旨在评估FODMAP饮食对肠道准备质量和腺瘤检出率（ADR）的影响。
这是一项多中心前瞻性队列研究，纳入在中国两个中心连续接受结肠镜检查的患者。患者被分为两组：高FODMAP饮食组或非高FODMAP饮食组。使用ODMP软件识别FODMAP饮食类型。主要结局是ADR；次要结局是肠道准备质量，通过波士顿肠道准备量表和气泡评分来衡量。
共纳入365例患者。高FODMAP饮食组患者的肠道清洁效果较差：波士顿肠道准备量表评分≥6分的比例为76.8%，而另一组为90.3%（P<0.01），气泡评分为2.42±1.69，而另一组为1.32±1.63（P<0.001）。高FODMAP饮食组的插管时间明显更长（7.07±5.18 vs. 5.46±3.05分钟；P = 0.002）。高FODMAP饮食是肠道准备不充分的独立风险预测因素。两组饮食组之间的ADR没有统计学显著差异。
高FODMAP饮食显著降低了肠道准备质量。我们建议在肠道准备中采用非高FODMAP饮食作为饮食方案的参考标准。该方法有效、灵活、可参考且耐受性良好，有助于为患者在肠道准备中提供有价值的饮食指导。
