Weznaver Cecilia, Nybacka Sanna, Simren Magnus, Törnblom Hans, Jakobsson Sofie, Störsrud Stine
Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Center for Functional GI and Motility Disorders, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA.
J Hum Nutr Diet. 2024 Oct;37(5):1336-1348. doi: 10.1111/jhn.13349. Epub 2024 Aug 13.
Diet plays an important role in management of gastrointestinal (GI) symptoms in patients with irritable bowel syndrome (IBS). Restrictive diets have gained popularity as treatment for IBS, but no studies have examined the patients' experiences of implementing such diets. Thus, the present study aimed to explore the experience of patients with IBS undergoing a structured dietary intervention.
Using inductive content analysis, semi-structured interviews were conducted in 19 patients with IBS, who were recruited from a randomised controlled trial evaluating two different restrictive diets for 4 weeks: a diet low in total carbohydrates; and a diet low in fermentable oligo-, di- and monosaccharides and polyols (i.e., FODMAP) combined with traditional IBS dietary advice.
Three main themes developed from the qualitative analysis and together they describe the dietary intervention as supportive, as well as the dietary changes as challenging and contributing to reflection. Patients found the dietary support effective in both initiating and adhering to their dietary changes. Despite the support, the implementation of the diet was perceived as challenging when it interfered with other important aspects of their lives. However, going through the dietary change process, the patients began to reflect on their eating behaviours, which enabled individual dietary adjustments. The adjustments that patients maintained were not only a result of alleviation of GI symptoms, but also based on personal preferences.
Patients with IBS undergoing restrictive diets appear to benefit from structured support. However, considering the individual patient's life situation and personal preferences, individualised dietary options should be encouraged to achieve long-term dietary changes.
饮食在肠易激综合征（IBS）患者胃肠道（GI）症状的管理中起着重要作用。限制性饮食作为IBS的治疗方法越来越受欢迎，但尚无研究考察患者实施此类饮食的体验。因此，本研究旨在探索接受结构化饮食干预的IBS患者的体验。
采用归纳性内容分析法，对19例IBS患者进行了半结构式访谈，这些患者来自一项随机对照试验，该试验评估了两种不同的限制性饮食，为期4周：一种是总碳水化合物含量低的饮食；另一种是低可发酵寡糖、双糖、单糖和多元醇（即FODMAP）饮食，并结合传统的IBS饮食建议。
定性分析得出了三个主要主题，它们共同将饮食干预描述为有支持性的，同时将饮食变化描述为具有挑战性且促使患者进行反思。患者发现饮食支持在启动和坚持饮食变化方面均有效。尽管有支持，但当饮食实施干扰到他们生活的其他重要方面时，仍被视为具有挑战性。然而，在经历饮食变化过程中，患者开始反思自己的饮食行为，从而能够进行个性化的饮食调整。患者维持的调整不仅是胃肠道症状缓解的结果，也是基于个人喜好。
接受限制性饮食的IBS患者似乎受益于结构化支持。然而，考虑到个体患者的生活状况和个人喜好,应鼓励采用个性化饮食方案以实现长期的饮食改变。
