Patcharatrakul Tanisa, Linlawan Sittikorn, Plaidum Suppawatsa, Gonlachanvit Sutep
Division of Gastroenterology, Department of Medicine, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok 10330, Thailand.
Center of Excellence on Neurogastroenterology and Motility, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
Foods. 2021 Dec 23;11(1):26. doi: 10.3390/foods11010026.
A randomized crossover study in twenty-one patients (18F, age 50 ± 13 years) with overlapping GERD-IBS was conducted to evaluate the effects of rice noodles (low FODMAPs) vs. wheat noodles (high FODMAPs) on typical GER symptoms, and the correlation between GERD symptoms and intestinal gas production. Results: Heartburn and regurgitation scores were highest in most patients (19/21) during the first 15 min after meals. At 15 min after lunch, wheat was significantly associated with more regurgitation and heartburn than rice. Also, at 15 min after breakfast, wheat aggravated more regurgitation than rice. Wheat ingestion was significantly associated with higher H and CH levels after lunch compared to rice, whereas gas levels before lunch were similar ( > 0.05). The area under the curve of H and CH concentration 15 min after a lunch of wheat moderately correlated with the regurgitation severity at 15-min (r = 0.56, < 0.05). Conclusion: Wheat induced more GERD symptoms than rice in patients with overlapping GERD-IBS. This effect, immediately developed after lunch, was associated with more intestinal gas production. Thus, a low FODMAPs diet may relieve postprandial GERD symptoms in GERD patients with overlapping IBS. Wheat inducing more regurgitation than rice after breakfast suggests other mechanism(s) besides gut fermentation.
对21例（18名女性，年龄50±13岁）患有重叠性胃食管反流病-肠易激综合征的患者进行了一项随机交叉研究，以评估米粉（低可发酵碳水化合物）与小麦面条（高可发酵碳水化合物）对典型胃食管反流症状的影响，以及胃食管反流病症状与肠道气体产生之间的相关性。结果：大多数患者（19/21）在饭后最初15分钟内心酸和反流评分最高。午餐后15分钟时，食用小麦比食用大米明显会导致更多的反流和烧心。此外，早餐后15分钟时，食用小麦比食用大米会加重更多反流。与大米相比，午餐后食用小麦与更高的氢气和甲烷水平显著相关，而午餐前的气体水平相似（P>0.05）。午餐食用小麦后15分钟时氢气和甲烷浓度曲线下面积与15分钟时反流严重程度中度相关（r = 0.56，P<0.05）。结论：在患有重叠性胃食管反流病-肠易激综合征的患者中，小麦比大米诱发更多的胃食管反流病症状。这种效应在午餐后立即出现，与更多的肠道气体产生有关。因此，低可发酵碳水化合物饮食可能会缓解患有重叠性肠易激综合征的胃食管反流病患者的餐后胃食管反流症状。早餐后小麦比大米诱发更多反流表明除肠道发酵外还存在其他机制。
