Clinical Department of Internal Medicine and Gastroenterology with Inflammatory Bowel Disease Subunit, Central Clinical Hospital of Ministry of the Interior and Administration, 02-507 Warsaw, Poland.
Collegium Medicum, Jan Kochanowski University, 25-369 Kielce, Poland.
Nutrients. 2022 Oct 29;14(21):4562. doi: 10.3390/nu14214562.
Approximately 30% of patients with quiescent inflammatory bowel disease (IBD) meet the diagnostic criteria for irritable bowel syndrome (IBS). The aim of this study was to evaluate the effectiveness of a low-FODMAP diet in patients who meet the diagnostic criteria for IBS whilst in IBD remission. A total of 200 patients in remission of IBD were included in the study. Sixty-five of these patients (32.5%) were diagnosed with IBS according to the R4DQ. On the patients who met the IBS diagnostic criteria, anthropometric measurements, laboratory tests and lactulose hydrogen breath tests were performed. A low-FODMAP diet was introduced for 6 weeks. Of the 59 patients with IBS diagnosed at baseline for whom data were collected at the end of follow-up, after the low-FODMAP intervention IBS-like symptoms were not present in 66.1% ( = 39) (95% CI (53.4%; 76.9%)). The difference between the two groups (with SIBO at baseline (33 of 48 patients) and without SIBO at baseline (6 of 11 patients)) in the low-FODMAP diet's effectiveness was not statistically significant ( = 0.586). The low-FODMAP diet improved the gut symptoms of flatulence and diarrhea. It had no effect on the occurrence of constipation. In IBD patients in remission who meet the IBS criteria, the dietary intervention of a low-FODMAP diet is effective for a reduction in IBS-like symptoms, regardless of the coexistence of bacterial overgrowth.
约 30%的静止期炎症性肠病 (IBD) 患者符合肠易激综合征 (IBS) 的诊断标准。本研究旨在评估低 FODMAP 饮食在 IBD 缓解期符合 IBS 诊断标准的患者中的有效性。共有 200 例 IBD 缓解期患者纳入本研究。其中 65 例（32.5%）根据 R4DQ 诊断为 IBS。对符合 IBS 诊断标准的患者进行人体测量、实验室检查和乳果糖氢呼气试验。引入低 FODMAP 饮食 6 周。在基线时诊断为 IBS 的 59 例患者中，有数据在随访结束时收集，在低 FODMAP 干预后，66.1%（=39）（95%CI（53.4%；76.9%））的患者没有出现 IBS 样症状。两组之间（基线时有 SIBO（48 例中的 33 例）和基线时没有 SIBO（11 例中的 6 例））在低 FODMAP 饮食有效性方面的差异无统计学意义（=0.586）。低 FODMAP 饮食改善了腹胀和腹泻等肠道症状，但对便秘的发生没有影响。在缓解期符合 IBS 标准的 IBD 患者中，无论是否存在细菌过度生长，低 FODMAP 饮食干预对减少 IBS 样症状都是有效的。
