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乳糖吸收不良、乳糜泻及相关疾病患者的营养

Nutrition in Patients with Lactose Malabsorption, Celiac Disease, and Related Disorders.

机构信息

Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Texas Southwestern, Dallas, TX 75235, USA.

出版信息

Nutrients. 2021 Dec 21;14(1):2. doi: 10.3390/nu14010002.

Abstract

Lactose malabsorption (LM), celiac disease (CD), non-celiac gluten sensitivity (NCGS), and irritable bowel syndrome (IBS) are conditions associated with food triggers, improvement after withdrawal, treatment with dietary restriction, and subsequent nutritional detriments. LM occurs when there is incomplete hydrolysis of lactose due to lactase deficiency and frequently produces abdominal symptoms; therefore, it can cause lactose intolerance (LI). A lactose-restricted diet is frequently recommended, although it can potentially lead to nutrient deficiencies. Furthermore, lactose is an essential component of fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) and is subsequently associated with intolerance to these compounds, especially in IBS. LM commonly presents in CD. Nutritional deficits are common in CD and can continue even on a gluten-free diet (GFD). Conditions triggered by gluten are known as gluten-related disorders (GRDs), including CD, wheat allergy, and NCGS. IBS can also be associated with a gluten sensitivity. A GFD is the treatment for CD, GRDs, and gluten sensitive IBS, although compliance with this restricted diet can be difficult. Strict dietary therapies can have a negative effect on quality of life. This review aims to provide an overview of the difficult nutritional elements of these disorders, which are critical for medical providers to recognize when managing these patients.

摘要

乳糖吸收不良(LM)、乳糜泻(CD)、非乳糜泻麸质敏感(NCGS)和肠易激综合征(IBS)是与食物诱因相关的疾病,这些疾病在停止摄入相关食物后会有所改善,通过饮食限制进行治疗,随后会出现营养不足的情况。当乳糖酶缺乏导致乳糖不完全水解时就会发生 LM,并且常常会产生腹部症状,因此,它可能导致乳糖不耐受(LI)。虽然乳糖限制饮食通常是推荐的,但它可能会导致营养不足。此外,乳糖是可发酵寡糖、二糖和单糖及多元醇(FODMAPs)的重要组成部分,因此随后与这些化合物不耐受有关,尤其是在 IBS 中。LM 通常在 CD 中出现。CD 常见营养不足,即使在无麸质饮食(GFD)中也会持续存在。由麸质触发的病症被称为麸质相关疾病(GRD),包括 CD、小麦过敏和 NCGS。IBS 也可能与麸质敏感性相关。GFD 是 CD、GRD 和麸质敏感 IBS 的治疗方法,尽管遵守这种限制饮食可能很困难。严格的饮食疗法可能会对生活质量产生负面影响。本综述旨在概述这些疾病的困难营养元素,这对医疗保健提供者在管理这些患者时识别这些元素非常重要。

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