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肠易激综合征患者的麸质挑战试验:一项随机单盲对照临床试验。

Effects of a gluten challenge in patients with irritable bowel syndrome: a randomized single-blind controlled clinical trial.

机构信息

Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Sci Rep. 2022 Mar 23;12(1):4960. doi: 10.1038/s41598-022-09055-6.


DOI:10.1038/s41598-022-09055-6
PMID:35322144
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8943127/
Abstract

Non-celiac gluten sensitivity (NCGS) and irritable bowel syndrome (IBS) frequently overlap. Although, gluten-free diet (GFD) and low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) improve the IBS clinical picture, many aspects remain unclear. Therefore, we designed a study to evaluate gluten tolerance, anxiety and quality of life in a specific study population. Fifty IBS patients were asked to follow a low FODMAP strict GFD for 6 weeks and were then randomly allocated to the following groups for a further 6 weeks: (A) receiving 8 g/day of gluten for 2 weeks; gluten-tolerating subjects received 16 g/day for 2 weeks and then 32 g/day for a further 2 weeks; (B) continuing to follow a low FODMAP strict GFD; and (C) receiving a gluten-containing diet. After the first 6 weeks, symptom scores significantly improved. Pain severity, bloating and total score were significantly decreased in the GFD and in the high-gluten groups, while the satiety score significantly increased in group C. Between-group analysis revealed significant differences for pain severity (p = 0.02), pain frequency (p = 0.04) and impact on community function (p = 0.02) at the end of the study. Our findings suggest that low FODMAP strict GFD could be prescribed in IBS patients and would reduce anxiety and improve the quality of life.

摘要

非乳糜泻麸质敏感(NCGS)和肠易激综合征(IBS)经常重叠。虽然无麸质饮食(GFD)和低可发酵寡糖、双糖、单糖和多元醇(FODMAP)可以改善 IBS 的临床症状,但仍有许多方面不清楚。因此,我们设计了一项研究,以评估特定研究人群中的麸质耐受性、焦虑和生活质量。50 名 IBS 患者被要求遵循低 FODMAP 严格 GFD 饮食 6 周,然后随机分为以下组进行进一步的 6 周治疗:(A)接受 8g/d 的麸质 2 周;麸质耐受的患者接受 16g/d 的麸质 2 周,然后再接受 32g/d 的麸质 2 周;(B)继续遵循低 FODMAP 严格 GFD 饮食;(C)接受含麸质的饮食。在第一阶段的 6 周后,症状评分显著改善。GFD 和高麸质组的疼痛严重程度、腹胀和总分显著降低,而 C 组的饱腹感评分显著增加。组间分析显示,在研究结束时,疼痛严重程度(p=0.02)、疼痛频率(p=0.04)和对社区功能的影响(p=0.02)方面存在显著差异。我们的研究结果表明,低 FODMAP 严格 GFD 可以在 IBS 患者中使用,并能减轻焦虑和改善生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99dc/8943127/a09d0c453106/41598_2022_9055_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99dc/8943127/a09d0c453106/41598_2022_9055_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99dc/8943127/a09d0c453106/41598_2022_9055_Fig1_HTML.jpg

相似文献

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引用本文的文献

[1]
Non-Celiac Gluten/Wheat Sensitivity-State of the Art: A Five-Year Narrative Review.

Nutrients. 2025-1-8

[2]
Efficacy of Dietary Interventions for Irritable Bowel Syndrome: A Systematic Review and Network Meta-Analysis.

J Clin Med. 2024-12-11

[3]
Efficacy and Safety of a Low-FODMAP Diet in Combination with a Gluten-Free Diet for Adult Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis.

Dig Dis Sci. 2024-11

[4]
The Latest Data Concerning the Etiology and Pathogenesis of Irritable Bowel Syndrome.

J Clin Med. 2024-8-29

[5]
The Role of Diet in the Management of Irritable Bowel Syndrome: A Comprehensive Review.

Cureus. 2024-2-15

[6]
Gluten restriction in irritable bowel syndrome, yes or no?: a GRADE-assessed systematic review and meta-analysis.

Front Nutr. 2023-11-1

[7]
A systematic review and meta-analysis of diet and nutrient intake in adults with irritable bowel syndrome.

Neurogastroenterol Motil. 2024-1

[8]
Irritable Bowel Syndrome: Treating the Gut and Brain/Mind at the Same Time.

Cureus. 2023-8-13

本文引用的文献

[1]
Influence of low FODMAP-gluten free diet on gut microbiota alterations and symptom severity in Iranian patients with irritable bowel syndrome.

BMC Gastroenterol. 2021-7-14

[2]
Evaluating Responses to Gluten Challenge: A Randomized, Double-Blind, 2-Dose Gluten Challenge Trial.

Gastroenterology. 2021-2

[3]
Worldwide Prevalence and Burden of Functional Gastrointestinal Disorders, Results of Rome Foundation Global Study.

Gastroenterology. 2021-1

[4]
Anxiety Symptoms in Adult Celiac Patients and the Effect of a Gluten-Free Diet: An Iranian Nationwide Study.

Inflamm Intest Dis. 2020-2

[5]
Evaluation of Non-Celiac Gluten Sensitivity in Patients with Previous Diagnosis of Irritable Bowel Syndrome: A Randomized Double-Blind Placebo-Controlled Crossover Trial.

Nutrients. 2020-3-6

[6]
Gluten and FODMAPS-Sense of a Restriction/When Is Restriction Necessary?

Nutrients. 2019-8-20

[7]
Is Bacillus coagulans supplementation plus low FODMAP diet superior to low FODMAP diet in irritable bowel syndrome management?

Eur J Nutr. 2020-8

[8]
European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders.

United European Gastroenterol J. 2019-4-13

[9]
Clinical application of dietary therapies in irritable bowel syndrome.

J Gastrointestin Liver Dis. 2018-9

[10]
A Low FODMAP Gluten-Free Diet Improves Functional Gastrointestinal Disorders and Overall Mental Health of Celiac Disease Patients: A Randomized Controlled Trial.

Nutrients. 2018-8-4

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