可发酵、低聚糖、双糖、单糖和多元醇(FODMAP)膳食对重叠肠易激综合征(IBS)的胃食管反流病(GERD)患者短暂性食管下括约肌松弛(TLESR)的影响。
The Effect of Fermentable, Oligosaccharides, Disaccharides, Monosaccharides, and Polyols (FODMAP) Meals on Transient Lower Esophageal Relaxations (TLESR) in Gastroesophageal Reflux Disease (GERD) Patients with Overlapping Irritable Bowel Syndrome (IBS).
机构信息
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.
出版信息
Nutrients. 2022 Apr 22;14(9):1755. doi: 10.3390/nu14091755.
A randomized crossover study in eight patients (6 F, age 57 ± 13) with overlapping GERD-IBS (non-constipation) was conducted to evaluate the effects of rice noodle vs. wheat noodle meals for breakfast and lunch on postprandial TLESR, intestinal gas production, and GERD/GI symptoms. Results: Wheat ingestion was significantly associated with more frequent TLESR after lunch than rice (5.0 ± 0.7 vs. 1.9 ± 0.3 times/2 h, p = 0.01). After lunch, wheat ingestion was significantly associated with higher H2 and CH4 levels compared to rice ingestion (p < 0.05), while H2 and CH4 levels before lunch were similar (p > 0.05). The area under curve of H2 concentration until 2 h after lunch significantly correlated with the TLESR number (r = 0.69, p = 0.04). Postprandial regurgitation (2.9 ± 1.2 vs. 0.4 ± 0.2), bloating (7.0 ± 0.4 vs. 3.1 ± 0.9), satiety (7.7 ± 0.4 vs. 3.5 ± 0.9), and belching (3.8 ± 1.2 vs. 1.1 ± 0.6) symptom scores were significantly greater after wheat compared to rice noodle ingestion (p < 0.05). Conclusion: Wheat noodle meals, part of a high FODMAP diet, induced a higher frequency of TLESRs, a higher GERD, and higher upper-GI symptom scores than rice noodle meals, part of a low FODMAP diet, in patients with overlapping IBS-GERD. These effects were associated with more intestinal gas production. Thus, a low FODMAP diet may relieve GERD symptoms in GERD patients with overlapping IBS.
一项纳入 8 例重叠型 GERD-IBS(非便秘型)患者(6 例女性,年龄 57 ± 13 岁)的随机交叉研究评估了早餐和午餐时食用米饭面条与小麦面条对餐后 TLESR、肠道气体生成和 GERD/GI 症状的影响。结果:与米饭相比,小麦摄入后午餐时 TLESR 更频繁(5.0 ± 0.7 次/2 h 比 1.9 ± 0.3 次/2 h,p = 0.01)。与米饭摄入相比,小麦摄入后午餐时 H2 和 CH4 水平更高(p < 0.05),而午餐前 H2 和 CH4 水平相似(p > 0.05)。午餐后 2 h 内 H2 浓度曲线下面积与 TLESR 次数显著相关(r = 0.69,p = 0.04)。与米饭摄入相比,小麦摄入后餐后反流(2.9 ± 1.2 比 0.4 ± 0.2)、腹胀(7.0 ± 0.4 比 3.1 ± 0.9)、饱腹感(7.7 ± 0.4 比 3.5 ± 0.9)和呃逆(3.8 ± 1.2 比 1.1 ± 0.6)症状评分更高(p < 0.05)。结论:小麦面条餐(高 FODMAP 饮食的一部分)比米饭面条餐(低 FODMAP 饮食的一部分)更能诱发重叠型 IBS-GERD 患者 TLESR 更频繁发生、GERD 更严重和上消化道症状评分更高,这与肠道气体生成增加有关。因此,低 FODMAP 饮食可能缓解重叠型 IBS 的 GERD 患者的 GERD 症状。
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