Shams Muhammad, Ahmed Junaid, Umar Aqsa, Rehman Abdur, Sohail Komal, Javed Bushra, Mustafa Raza, Payal Fnu, Shehryar Abdullah, Khan Mustafa
Urology, Royal Bournemouth Hospital, Bournemouth, GBR.
Internal Medicine, Chandka Medical College, Larkana, PAK.
Cureus. 2024 Sep 30;16(9):e70568. doi: 10.7759/cureus.70568. eCollection 2024 Sep.
This systematic review synthesizes findings from 12 studies to evaluate the effectiveness of dietary interventions in managing irritable bowel syndrome (IBS), with a focus on low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diets, probiotics, and prebiotics. The review rigorously follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and includes studies selected through comprehensive database searches. In adults diagnosed with IBS, this review assesses how effective dietary interventions, specifically low-FODMAP diets, probiotics, and prebiotics, are compared to standard management or placebo in improving clinical outcomes, modifying gut microbiota composition, and reducing inflammatory markers. Our analysis reveals that low-FODMAP diets consistently alleviate IBS symptoms and improve quality of life. However, the effectiveness of probiotics and prebiotics varies, with outcomes dependent on specific strains and individual patient microbiota profiles. The studies demonstrate significant improvements in gastrointestinal symptoms and microbiota composition, highlighting the potential of dietary strategies to beneficially modify gut health. However, the research points to the necessity of personalizing dietary approaches based on individual responses and microbiota profiles to optimize treatment efficacy. The risk of bias was assessed using the Cochrane risk-of-bias 2 tool for randomized controlled trials (RCTs) and the AMSTAR 2 tool for systematic reviews, with varying degrees of bias across the studies. This review identifies gaps in the long-term efficacy of these interventions and calls for more extensive trials to explore their sustained impacts. Our findings suggest that dietary management should be integrated into routine IBS treatment protocols and emphasize the need for further research to establish standardized dietary recommendations tailored to patient-specific characteristics.
本系统评价综合了12项研究的结果，以评估饮食干预对肠易激综合征（IBS）的管理效果，重点关注低FODMAP（可发酵寡糖、双糖、单糖和多元醇）饮食、益生菌和益生元。该评价严格遵循PRISMA（系统评价和Meta分析的首选报告项目）指南，并纳入了通过全面数据库检索选定的研究。在被诊断为IBS的成年人中，本评价评估饮食干预，特别是低FODMAP饮食、益生菌和益生元，与标准管理或安慰剂相比，在改善临床结局、改变肠道微生物群组成和降低炎症标志物方面的效果如何。我们的分析表明，低FODMAP饮食能持续缓解IBS症状并改善生活质量。然而，益生菌和益生元的效果各不相同，其结果取决于特定菌株和个体患者的微生物群特征。这些研究表明胃肠道症状和微生物群组成有显著改善，突出了饮食策略对有益改变肠道健康的潜力。然而，研究指出有必要根据个体反应和微生物群特征对饮食方法进行个性化定制，以优化治疗效果。使用Cochrane随机对照试验（RCT）偏倚风险2工具和AMSTAR 2系统评价工具评估偏倚风险，各研究的偏倚程度不同。本评价确定了这些干预措施长期疗效方面的差距，并呼吁进行更广泛的试验以探索其持续影响。我们的研究结果表明，饮食管理应纳入常规IBS治疗方案，并强调需要进一步研究以制定针对患者特定特征的标准化饮食建议。
