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通过饮食调整恢复肠道微生物群并管理肠易激综合征的症状

Dietary Modification for the Restoration of Gut Microbiome and Management of Symptoms in Irritable Bowel Syndrome.

作者信息

Thomas Andrew, Thomas Annie, Butler-Sanchez Madeline

机构信息

Bharati Vidyapeeth Medical College, Pune, India, and University of Illinois Health Sciences System, Chicago, Illinois.

Marcella Niehoff School of Nursing, Loyola University Chicago, Illinois.

出版信息

Am J Lifestyle Med. 2021 May 10;16(5):608-621. doi: 10.1177/15598276211012968. eCollection 2022 Sep-Oct.

Abstract

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder leading to chronic debilitating issues. A healthy diet plays an integral role in maintaining the gut microbiota equilibrium, thus promoting digestive health. The structure and function of gut microbiota are affected by genetics and environmental factors, such as altered dietary habits, gastroenteritis, stress, increased use of alcohol and drugs, and medication use. Whereas there are various management approaches cited in the literature to manage symptoms of IBS, the purpose of this article is to focus on dietary options that will restore the gut microbiome and help in managing IBS symptoms. Some of the diets that are discussed in this article include a low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet, gluten-free/wheat-free diet, high-fiber diet, dietary and herbal supplements (psyllium, peppermint oil), and probiotics/prebiotics/synbiotics. The clinical practice guidelines recommended by the American College of Gastroenterology outlines evidence-based dietary recommendations for patients with IBS to manage symptoms. Recent advancements in the dietary management of IBS highlighting the use of a patient-centered, personalized nutrition approach along with lifestyle changes, pharmacological therapies, and psychosocial and behavioral interventions are also reviewed and discussed.

摘要

肠易激综合征(IBS)是一种导致慢性衰弱问题的功能性胃肠疾病。健康饮食在维持肠道微生物群平衡从而促进消化健康方面起着不可或缺的作用。肠道微生物群的结构和功能受遗传和环境因素影响,如饮食习惯改变、肠胃炎、压力、酒精和药物使用增加以及药物治疗。虽然文献中提到了多种管理IBS症状的方法,但本文的目的是关注能够恢复肠道微生物群并有助于管理IBS症状的饮食选择。本文讨论的一些饮食包括低FODMAP(可发酵寡糖、双糖、单糖和多元醇)饮食、无麸质/无小麦饮食、高纤维饮食、膳食和草药补充剂(车前草、薄荷油)以及益生菌/益生元/合生元。美国胃肠病学会推荐的临床实践指南概述了针对IBS患者管理症状的循证饮食建议。本文还回顾并讨论了IBS饮食管理方面的最新进展,重点是采用以患者为中心的个性化营养方法以及生活方式改变、药物治疗和心理社会及行为干预。

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引用本文的文献

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ACG Clinical Guideline: Management of Irritable Bowel Syndrome.ACG 临床指南:肠易激综合征的管理。
Am J Gastroenterol. 2021 Jan 1;116(1):17-44. doi: 10.14309/ajg.0000000000001036.
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Gut microbiota and its mysteries.肠道微生物群及其奥秘。
Indian J Med Microbiol. 2019 Apr-Jun;37(2):268-277. doi: 10.4103/ijmm.IJMM_19_373.
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Diet-microbiota interactions and personalized nutrition.饮食-微生物群相互作用与个性化营养。
Nat Rev Microbiol. 2019 Dec;17(12):742-753. doi: 10.1038/s41579-019-0256-8. Epub 2019 Sep 20.

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