Jung Kee Wook, Myung Seung-Jae
Department of Gastroenterology, Asan Medical Center and Digestive Diseases Research Center, University of Ulsan College of Medicine, Seoul, Korea.
Intest Res. 2023 Apr;21(2):189-195. doi: 10.5217/ir.2021.00136. Epub 2022 May 31.
Irritable bowel syndrome (IBS) is a prevalent chronic disorder, and its epidemiology depends on the diagnostic criteria used. Recently, the Rome IV criteria for IBS were published by changing the frequency of abdominal pain and excluding abdominal discomfort from the previously used Rome III criteria. However, the recent Asian consensus on IBS recommends the inclusion of abdominal discomfort and abdominal pain as diagnostic criteria. The low fermentable oligo-, di-, mono-saccharides, and polyols (FODMAP) diet has been proven to be effective in Western patients. Moreover, recent well-designed studies reported its effectiveness and the microbial changes after implementing it in Asian patients with IBS. However, traditional Korean foods including kimchi, one of representative FODMAP-rich food, exhibited a poor correlation with the food-related symptoms of IBS. Therefore, the low FODMAP diet protocol should be cautiously applied to IBS patients, especially to Korean patients with IBS. In Asian countries, there are lots of traditional herbal medicines and treatments for IBS; however, these studies have limitations including the heterogeneity of herbal mixtures and relatively small sample size. Therefore, well-designed studies based on large samples are required to validate complementary and alternative medicine in the treatment of Asian patients with IBS.
肠易激综合征（IBS）是一种常见的慢性疾病，其流行病学情况取决于所使用的诊断标准。最近，IBS的罗马IV标准发布，改变了腹痛的频率，并将腹部不适从先前使用的罗马III标准中排除。然而，最近关于IBS的亚洲共识建议将腹部不适和腹痛纳入诊断标准。低可发酵寡糖、双糖、单糖和多元醇（FODMAP）饮食已被证明对西方患者有效。此外，最近设计良好的研究报告了其在亚洲IBS患者中实施后的有效性及微生物变化。然而，包括泡菜在内的传统韩国食物，是富含FODMAP的代表性食物之一，与IBS的食物相关症状相关性较差。因此，低FODMAP饮食方案应谨慎应用于IBS患者，尤其是韩国IBS患者。在亚洲国家，有许多用于治疗IBS的传统草药和疗法；然而，这些研究存在局限性，包括草药混合物的异质性和样本量相对较小。因此，需要基于大样本的设计良好的研究来验证补充和替代医学在治疗亚洲IBS患者中的作用。
