Nakano Kaoru, Takahashi Tomoko, Tsunoda Akira, Shimizu Yukiko
Kameda Kyobashi Clinic, Tokyo, Japan.
Department of Gastroenterological Surgery, Kameda Medical Center, Chiba, Japan.
J Anus Rectum Colon. 2020 Jul 30;4(3):128-136. doi: 10.23922/jarc.2020-008. eCollection 2020.
Dietary fiber (DF) supplements improve fecal incontinence (FI). Here, we investigated the effects of dietary guidance without DF supplements in patients with FI.
This was an interventional study on the nutritional guidance alone by a dietitian where outcomes were compared before and one month after the guidance. In this study, participants attended a one 20-min dietary guidance session and received individual guidance on dietary management according to the 2017 Japanese FI guidelines, between January 2016 and March 2019. The main assessment items used were as follows: (i) the Fecal Incontinence Severity Index (FISI) to assess symptoms, (ii) the Fecal Incontinence Quality of Life Scale (FIQL) to assess the quality of life, and (iii) the dietary intake per day.
Out of 61 patients who participated in this study, 50 (82%) completed the entire study and 29 (48%) continued a self-controlled diet therapy without drug treatment. Of the 50 patients, the FISI and FIQL scores were significantly improved after the guidance (FISI: 19 before vs. 10.5 after, P < 0.001; FIQL: 2.9 before vs. 3.2 after, P < 0.001). There was no statistically significant difference in the overall DF intake before and after the dietary guidance. However, foods containing DF changed significantly after the guidance. The intake of rice was significantly increased, whilst that of fruits, dairy products, and confectioneries was significantly reduced after the guidance.
Individual dietary guidance without DF supplements was effective. These results suggested that increasing rice consumption and restricting some foods had positive effects on improving FI.
膳食纤维(DF)补充剂可改善大便失禁(FI)。在此,我们研究了在FI患者中不使用DF补充剂的饮食指导效果。
这是一项仅由营养师进行营养指导的干预性研究,比较指导前和指导后1个月的结果。在本研究中,参与者在2016年1月至2019年3月期间参加了一次20分钟的饮食指导课程,并根据2017年日本FI指南接受了饮食管理的个性化指导。主要评估项目如下:(i)用于评估症状的大便失禁严重程度指数(FISI);(ii)用于评估生活质量的大便失禁生活质量量表(FIQL);(iii)每日饮食摄入量。
在参与本研究的61名患者中,50名(82%)完成了整个研究,29名(48%)在未进行药物治疗的情况下继续进行自我控制饮食疗法。在这50名患者中,指导后FISI和FIQL评分显著改善(FISI:指导前为19,指导后为10.5,P<0.001;FIQL:指导前为2.9,指导后为3.2,P<0.001)。饮食指导前后总的DF摄入量无统计学显著差异。然而,指导后含DF的食物有显著变化。指导后大米摄入量显著增加,而水果、乳制品和糖果的摄入量显著减少。
不使用DF补充剂的个性化饮食指导是有效的。这些结果表明,增加大米摄入量和限制某些食物对改善FI有积极作用。