Department of Gastroenterology, Xiangya Hospital, Central South University, Changsha 410008, China.
Hunan International Scientific and Technological Cooperation Base of Artificial Intelligence Computer-Aided Diagnosis and Treatment for Digestive Disease, Changsha 410008, China.
Nutrients. 2022 May 15;14(10):2072. doi: 10.3390/nu14102072.
A low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet (LFD) is claimed to improve functional gastrointestinal symptoms (FGSs). However, the role of LFD in inflammatory bowel disease (IBD) patients with FGSs remains unclear.
To systematically assess the efficacy of LFD in IBD patients with FGSs.
Six databases were searched from inception to 1 January 2022. Data were synthesized as the relative risk of symptoms improvement and normal stool consistency, mean difference of Bristol Stool Form Scale (BSFS), Short IBD Questionnaire (SIBDQ), IBS Quality of Life (IBS-QoL), Harvey-Bradshaw index (HBi), Mayo score, and fecal calprotectin (FC). Risk of bias was assessed based on study types. A funnel plot and Egger's test were used to analyze publication bias.
This review screened and included nine eligible studies, including four randomized controlled trials (RCTs) and five before-after studies, involving a total of 446 participants (351 patients with LFD vs. 95 controls). LFD alleviated overall FGSs (RR: 0.47, 95% CI: 0.33-0.66, = 0.0000) and obtained higher SIBDQ scores (MD = 11.24, 95% CI 6.61 to 15.87, = 0.0000) and lower HBi score of Crohn's disease (MD = -1.09, 95% CI -1.77 to -0.42, = 0.002). However, there were no statistically significant differences in normal stool consistency, BSFS, IBS-QoL, Mayo score of ulcerative colitis, and FC. No publication bias was found.
LFD provides a benefit in FGSs and QoL but not for improving stool consistency and mucosal inflammation in IBD patients. Further well-designed RCTs are needed to develop the optimal LFD strategy for IBD.
低发酵性寡糖、双糖、单糖和多元醇饮食（LFD）据称可改善功能性胃肠症状（FGS）。然而，LFD 在有 FGS 的炎症性肠病（IBD）患者中的作用仍不清楚。
系统评估 LFD 在有 FGS 的 IBD 患者中的疗效。
从建库至 2022 年 1 月 1 日，检索了 6 个数据库。将症状改善和正常粪便稠度的相对风险、Bristol 粪便形态量表（BSFS）、短型 IBD 问卷（SIBDQ）、IBS 生活质量（IBS-QoL）、Harvey-Bradshaw 指数（HBi）、Mayo 评分和粪便钙卫蛋白（FC）的均值差值作为数据进行综合。根据研究类型评估偏倚风险。采用漏斗图和 Egger 检验分析发表偏倚。
本综述筛选并纳入了 9 项符合条件的研究，包括 4 项随机对照试验（RCT）和 5 项前后对照研究，共涉及 446 名参与者（351 名接受 LFD 治疗的患者与 95 名对照组）。LFD 缓解了总体 FGS（RR：0.47，95%CI：0.33-0.66， = 0.0000），并获得了更高的 SIBDQ 评分（MD = 11.24，95%CI 6.61 至 15.87， = 0.0000）和更低的克罗恩病 HBi 评分（MD = -1.09，95%CI -1.77 至 -0.42， = 0.002）。然而，在粪便正常稠度、BSFS、IBS-QoL、溃疡性结肠炎 Mayo 评分和 FC 方面，差异均无统计学意义。未发现发表偏倚。
LFD 对 FGS 和生活质量有益，但对改善 IBD 患者的粪便稠度和黏膜炎症无益处。需要进一步开展精心设计的 RCT 来制定 IBD 的最佳 LFD 策略。
