Lynda K and David M Underwood Center for Digestive Disorders, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas, USA.
Curr Opin Clin Nutr Metab Care. 2022 Jul 1;25(4):260-264. doi: 10.1097/MCO.0000000000000841.
Food ingestion is an exacerbator of gastrointestinal symptoms, regardless of origin. Sufferers mistakenly assume that they have suffered an allergic reaction to a given food. Although classical IgE-mediated allergic reactions are rarely culpable, evidence for a role for intolerance to certain carbohydrates in irritable bowel syndrome (IBS) and related conditions increases. This review assesses the status of a commonly implicated group of poorly absorbed carbohydrates (fermentable oligosaccharides, disaccharides, monosaccharides and polyols - FODMAPs) in gastrointestinal pathophysiology.
Although evidence of efficacy for low FODMAP diets in IBS accumulates, the magnitude of this effect has declined in recent studies. Comparisons to other dietary approaches have revealed conflicting results; some suggest superiority, others find parity. Concerns had been raised regarding long-term nutritional, psychological and microbiological impacts of FODMAP restriction; providing that the diet is administered in the recommended manner, these do not appear to be clinically important. The mechanisms whereby FODMAPs cause gastrointestinal symptoms continue to be explored.
FODMAPS induce gastrointestinal symptoms in susceptible individuals and their restriction provides clinical benefits. The magnitude of these benefits, the superiority of FODMAP restriction over other dietary approaches and the mechanisms of its effects continue to be defined.
无论来源如何，进食都会加重胃肠道症状。患者错误地认为他们对特定食物发生了过敏反应。尽管经典的 IgE 介导的过敏反应很少是罪魁祸首，但越来越多的证据表明，某些碳水化合物不耐受在肠易激综合征（IBS）和相关疾病中起作用。这篇综述评估了一组常见的不易吸收的碳水化合物（可发酵寡糖、双糖、单糖和多元醇-FODMAPs）在胃肠道病理生理学中的作用。
尽管低 FODMAP 饮食在 IBS 中的疗效证据不断增加，但最近的研究表明这种效果的幅度有所下降。与其他饮食方法的比较显示出相互矛盾的结果；一些研究表明其具有优越性，另一些则认为其相当。人们对 FODMAP 限制的长期营养、心理和微生物学影响表示担忧；只要按照推荐的方式进行饮食，这些似乎不会对临床产生重要影响。FODMAP 引起胃肠道症状的机制仍在探索中。
FODMAP 在易感个体中引起胃肠道症状，限制其摄入可提供临床益处。这些益处的幅度、FODMAP 限制相对于其他饮食方法的优越性及其作用机制仍在确定之中。
