Gastrointestinal Unit, Department of Translational Sciences and New Technologies in Medicine and Surgery, University of Pisa, 56010, Pisa, Italy.
Gastrointestinal Unit, Department of Translational Sciences and New Technologies in Medicine and Surgery, University of Pisa, 56010, Pisa, Italy.
Best Pract Res Clin Gastroenterol. 2023 Feb-Mar;62-63:101831. doi: 10.1016/j.bpg.2023.101831. Epub 2023 Apr 4.
Functional dyspepsia (FD) is a frequent disorder of gut-brain interaction, affecting 5-7% of people globally, with significant impairment in quality of life. The management of FD is challenging due to the lack of specific therapeutic approaches. Although food seems to play a role in symptom production, its pathophysiologic role in patients with FD is not fully understood. Most FD patients report that their symptoms are triggered by food, especially in the post-prandial distress syndrome (PDS) group, although evidence to support the use of dietary interventions are limited. FODMAPs can increase production of gas in the intestinal lumen, through fermentation by intestinal bacteria, can exert osmotic effects by increasing water volume and can cause an excessive production of short-chain fatty acids (propionate, butyrate, and acetate). Emerging scientific evidence, confirmed by recent clinical trials, suggest that FODMAPs could be involved in the pathogenesis of FD. Given the consolidated approach of the Low-FODMAP Diet (LFD) in irritable bowel syndrome (IBS) management and emerging scientific evidence regarding the LFD in FD, a therapeutic role of this diet may be hypothesized also in FD, either alone or in combination with other therapies.
功能性消化不良(FD)是一种常见的肠-脑相互作用紊乱,影响全球 5-7%的人群,生活质量受到严重影响。由于缺乏特定的治疗方法,FD 的治疗具有挑战性。尽管食物似乎在症状产生中起作用,但 FD 患者的食物的病理生理作用尚不完全清楚。大多数 FD 患者报告说他们的症状是由食物引起的,特别是在餐后不适综合征(PDS)组中,尽管支持饮食干预的证据有限。FODMAP 可通过肠道细菌发酵增加肠道腔内气体的产生,通过增加水量发挥渗透作用,并导致短链脂肪酸(丙酸、丁酸和乙酸)的过度产生。新兴的科学证据,以及最近的临床试验证实,FODMAP 可能与 FD 的发病机制有关。鉴于低 FODMAP 饮食(LFD)在肠易激综合征(IBS)管理中的综合方法,以及 LFD 在 FD 方面的新兴科学证据,这种饮食可能单独或与其他疗法联合在 FD 中具有治疗作用。
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