University of Manitoba IBD Clinical and Research Centre, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Department of Nutrition and Food Services, Health Sciences Centre, Winnipeg, Manitoba, Canada.
JPEN J Parenter Enteral Nutr. 2022 Sep;46(7):1686-1698. doi: 10.1002/jpen.2349. Epub 2022 Mar 20.
In this matched case-control longitudinal study among people living with inflammatory bowel disease (IBD), we investigated beliefs about what triggers a flare.
Adults with confirmed IBD and active disease within 2 years were enrolled in the Manitoba Living with IBD Study and followed biweekly with online surveys for 1 year. The 7-point IBD Symptom Change Indicator was used for participant identification of a flare. Flare cases were matched to non-flare controls by sex and disease type. Members of each matched pair completed supplementary information on diet changes and psychological functioning in the previous 2 weeks and provided stool samples to assess fecal calprotectin (FCAL).
Of 128 enrolled participants, 95 matched flare/non-flare pairs were created. Those reporting a flare were more likely to have elevated FCAL (51% vs 34% among non-flares, P = 0.043). Although 61% of study participants believed at baseline that a food may trigger flares, and 25% of those in a flare believed that a food may have triggered their current flare, there was no difference in consumption of assessed foods between flares and non-flares in the previous 2 weeks. Patients with flares were more likely to be having difficulties in emotional state than controls (40% vs 18%, P = 0.001) and more likely to be stressed or worried (64% vs 33%, P = 0.001).
Although a majority of individuals with IBD believe that specific foods trigger their disease flares, this was not supported by the current findings. Recent psychological functioning was associated with self-reported IBD flare.
在这项针对炎症性肠病（IBD）患者的匹配病例对照纵向研究中，我们调查了患者对疾病发作诱因的看法。
确诊为 IBD 且在 2 年内疾病处于活动期的成年人参加了曼尼托巴省 IBD 生活研究，并在接下来的 1 年内每两周进行一次在线调查。使用 IBD 症状变化指标来识别患者的疾病发作。根据性别和疾病类型，将疾病发作的病例与非发作的对照进行匹配。每对匹配的病例和对照都完成了关于前 2 周饮食变化和心理功能的补充信息，并提供粪便样本以评估粪便钙卫蛋白（FCAL）。
在 128 名入组的参与者中，有 95 对匹配的发作/非发作病例被创建。报告疾病发作的患者更有可能出现 FCAL 升高（发作组中 51%，非发作组中 34%，P=0.043）。尽管 61%的研究参与者在基线时认为某种食物可能引发疾病发作，并且 25%的发作患者认为某种食物可能引发了当前的发作，但在过去的 2 周内，发作组和非发作组摄入的评估食物并无差异。发作组的患者在情绪状态方面更有可能出现困难，比对照组多 40%（P=0.001），并且更有可能感到压力或担忧，比对照组多 64%（P=0.001）。
尽管大多数 IBD 患者认为特定食物会引发疾病发作，但这一观点与当前的研究结果并不相符。近期的心理功能与自我报告的 IBD 发作相关。
