Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals, Sheffield.
Academic Unit of Gastroenterology, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK.
Curr Opin Gastroenterol. 2023 May 1;39(3):219-226. doi: 10.1097/MOG.0000000000000930. Epub 2023 Mar 1.
Diet appears to trigger symptoms in the majority of individuals with irritable bowel syndrome (IBS) and is associated with a reduced quality of life. There has been a recent focus on the role of dietary therapies to manage individuals with IBS. The aim of this review is to discuss the utility of traditional dietary advice (TDA), low-FODMAP diet (LFD) and gluten-free diet (GFD) in IBS.
Several recent randomized controlled trials (RCTs) have been published demonstrating the efficacy of the LFD and GFD in IBS, with the evidence base for TDA being predominantly based on clinical experience, with emerging RCTs evaluating TDA. Only one RCT has been published to date comparing TDA, LFD and GFD head to head, with no difference noted between diets in terms of efficacy. However, TDA has been noted to be more patient-friendly and is commonly implemented as a first-line dietary therapy.
Dietary therapies have been demonstrated to improve symptoms in patients with IBS. In view of insufficient evidence to recommend one diet over another currently, specialist dietetic input in conjunction with patient preference is required to determine implementation of dietary therapies. Novel methods of dietetic delivery are required in view of the lack of dietetic provision to deliver these therapies.
饮食似乎会引发大多数肠易激综合征（IBS）患者的症状，并且与生活质量的降低有关。最近，人们关注饮食疗法在管理 IBS 患者中的作用。本综述旨在讨论传统饮食建议（TDA）、低 FODMAP 饮食（LFD）和无麸质饮食（GFD）在 IBS 中的应用。
最近发表了几项随机对照试验（RCT），证明了 LFD 和 GFD 在 IBS 中的疗效，而 TDA 的证据基础主要基于临床经验，新兴的 RCT 正在评估 TDA。迄今为止，只有一项 RCT 发表了比较 TDA、LFD 和 GFD 的头对头研究，结果显示三种饮食在疗效方面没有差异。然而，TDA 被认为更适合患者，并且通常作为一线饮食治疗。
饮食疗法已被证明可改善 IBS 患者的症状。鉴于目前尚无足够的证据推荐一种饮食优于另一种饮食，因此需要营养师的专业意见和患者的个人偏好来确定饮食疗法的实施。鉴于缺乏提供这些治疗的饮食服务，需要采用新的饮食服务提供方法。
