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