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低 FODMAP 饮食联合无麸质饮食治疗成人肠易激综合征的疗效和安全性:系统评价和荟萃分析。

Efficacy and Safety of a Low-FODMAP Diet in Combination with a Gluten-Free Diet for Adult Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis.

机构信息

School of Nursing, Yangzhou University, 136 Jiangyang Road, Yangzhou, Jiangsu, China.

Affiliated Hospital of Yangzhou University, No. 45, Taizhou Road, Yangzhou, Jiangsu, China.

出版信息

Dig Dis Sci. 2024 Nov;69(11):4124-4132. doi: 10.1007/s10620-024-08671-8. Epub 2024 Oct 15.


DOI:10.1007/s10620-024-08671-8
PMID:39407084
Abstract

BACKGROUND: Common gastrointestinal disease irritable bowel syndrome (IBS) is marked by symptoms like changed bowel habits, bloating, and stomach ache. A low-FODMAP combined gluten-free diet (LF-GFD) has been suggested as a possible therapy for IBS symptoms management. OBJECTIVE: This study sought to investigate whether a LF-GFD would help patients with IBS. METHODS: Strict inclusion and exclusion criteria from internet databases helped to identify clinical studies evaluating the intervention of LF-GFD in the treatment of IBS patients. Using measurements including the visual analog scale (VAS) for bloating and pain, the IBS symptom severity scale (IBS-SSS), and IBS quality of life (IBS-QoL), the main results evaluated were the efficacy of LF-GFD in reducing IBS symptoms. Furthermore assessed were the psychological impacts of LF-GFD utilizing the self- rating depression scale (SDS) and self- rating anxiety scale (SAS). RESULTS: A total of 437 patients (221 on LF-GFD diet and 216 on GFD) were involved in 4 randomized controlled trials and 4 cohort studies. The combined results indicated that LF-GFD reduced the VAS bloating ratings (RR = - 0.58, 95%CI - 0.92-0.23, P = 0.0010, I2 = 83%) and the VAS pain scores (RR = - 0.42, 95%CI - 0.66-0.19, P = 0.005, I2 = 58%). In addition, LF-GFD indicated a substantial enhancement in IBS-SSS scores (MD = - 1.42, 95%CI - 2.74-0.10, P = 0.03, I2 = 24%) and IBS-QoL ratings (MD = 3.75, 95%CI 0.98-6.53, P = 0.008, I2 = 33%). Moreover, the LF-GFD group showed a substantial drop in SDS (MD = - 2.56, 95%CI - 3.38-1.74, P < 0.00001, I2 = 65%) and SAS (MD = - 4.30, 95%CI - 6.53-2.24, P < 0.0001, I2 = 0%) scores compared to the GFD group. CONCLUSION: LF-GFD therapy significantly enhances clinical symptoms and reduces anxiety and depression in individuals diagnosed with irritable bowel syndrome.

摘要

背景:常见的胃肠道疾病肠易激综合征(IBS)的症状包括排便习惯改变、腹胀和腹痛。低 FODMAP 联合无麸质饮食(LF-GFD)已被提议作为 IBS 症状管理的一种可能疗法。

目的:本研究旨在探讨 LF-GFD 是否有助于 IBS 患者。

方法:从互联网数据库中严格的纳入和排除标准帮助确定了评估 LF-GFD 干预治疗 IBS 患者的临床研究。使用包括腹胀和疼痛的视觉模拟量表(VAS)、IBS 症状严重程度量表(IBS-SSS)和 IBS 生活质量量表(IBS-QoL)等测量方法,主要结果评估 LF-GFD 降低 IBS 症状的疗效。此外,利用自评抑郁量表(SDS)和自评焦虑量表(SAS)评估 LF-GFD 的心理影响。

结果:共有 437 名患者(LF-GFD 饮食组 221 名,GFD 饮食组 216 名)参与了 4 项随机对照试验和 4 项队列研究。综合结果表明,LF-GFD 降低了 VAS 腹胀评分(RR=-0.58,95%CI-0.92-0.23,P=0.0010,I2=83%)和 VAS 疼痛评分(RR=-0.42,95%CI-0.66-0.19,P=0.005,I2=58%)。此外,LF-GFD 显著改善了 IBS-SSS 评分(MD=-1.42,95%CI-2.74-0.10,P=0.03,I2=24%)和 IBS-QoL 评分(MD=3.75,95%CI 0.98-6.53,P=0.008,I2=33%)。此外,LF-GFD 组的 SDS(MD=-2.56,95%CI-3.38-1.74,P<0.00001,I2=65%)和 SAS(MD=-4.30,95%CI-6.53-2.24,P<0.0001,I2=0%)评分显著下降。

结论:LF-GFD 疗法可显著改善肠易激综合征患者的临床症状,并降低其焦虑和抑郁程度。

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引用本文的文献

[1]
Efficacy of Dietary Interventions for Irritable Bowel Syndrome: A Systematic Review and Network Meta-Analysis.

J Clin Med. 2024-12-11

本文引用的文献

[1]
Prevalence of Irritable Bowel Syndrome in Saudi Arabia: A Systematic Review and Meta-Analysis.

Cureus. 2023-9-16

[2]
A personalized management approach in disorders of the irritable bowel syndrome spectrum.

Clin Nutr ESPEN. 2023-10

[3]
Impact of different fibre ingredients on a low-FODMAP biscuit model system.

Food Funct. 2023-7-31

[4]
Evaluation of the effects of the FODMAP diet and probiotics on irritable bowel syndrome (IBS) symptoms, quality of life and depression in women with IBS.

J Hum Nutr Diet. 2024-2

[5]
Detection of changes in regional colonic fermentation in response to supplementing a low FODMAP diet with dietary fibres by hydrogen concentrations, but not by luminal pH.

Aliment Pharmacol Ther. 2023-8

[6]
The Efficacy of a Diet Low in Fermentable Oligo-, Di-, Monosaccharides, and Polyols in Irritable Bowel Syndrome Compared to Its "Real-world" Effectiveness: Protocol for a Systematic Review.

JMIR Res Protoc. 2023-6-12

[7]
Effects of a Low-FODMAP Diet on Irritable Bowel Syndrome in Both Children and Adults-A Narrative Review.

Nutrients. 2023-5-13

[8]
Nonceliac gluten sensitivity.

Curr Opin Clin Nutr Metab Care. 2023-9-1

[9]
The low-FODMAP diet and the gluten-free diet in the management of functional abdominal bloating and distension.

Front Nutr. 2022-11-8

[10]
Diagnostic management of patients reporting symptoms after wheat ingestion.

Front Nutr. 2022-10-6

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