Usai Satta Paolo, Mocci Giammarco, Lai Mariantonia
Gastroenterology Unit, ARNAS G. Brotzu, 09121 Cagliari, Italy.
Digestive Endoscopy, ARNAS G. Brotzu, 09121 Cagliari, Italy.
Nutrients. 2024 Dec 4;16(23):4190. doi: 10.3390/nu16234190.
Individuals with celiac disease (CD) often report the persistence of gastrointestinal symptoms despite adherence to a gluten-free diet (GFD). A diet rich in fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) could cause symptoms in CD on a GFD, and conversely a low-FODMAP diet could positively influence the therapeutic management of CD and non-celiac gluten sensitivity (NCGS). The aim of this review was to explore the hypothetical impact of the FODMAD diet and the low-FODMAP diet (LFD) in CD and gluten-related disorders.
A complete online search for FODMAP related to CD, NCGS, and the GFD was carried out using the Pubmed, Medline, and Cochrane databases.
Indeed, an LFD could successfully provide symptom relief in GFD-treated CD patients. Fructans, typical components of FODMAPs, have been associated with digestive symptoms in NCGS, and an LFD could improve the clinical picture. According to some evidence, an LFD could also improve the psychological status both in celiac patients on a GFD and in NCGS. However, an LFD should not have a significant impact on gut microbiota.
Recent evidence supports the role of FODMAP restriction in CD patients with persistent symptoms on a GFD and in decreasing gastrointestinal disturbances in NCGS, although the GFD still represents the first-line therapy.
乳糜泻（CD）患者常报告称，尽管坚持无麸质饮食（GFD），胃肠道症状仍持续存在。富含可发酵寡糖、双糖、单糖和多元醇（FODMAPs）的饮食可能会在采用GFD的CD患者中引发症状，相反，低FODMAP饮食可能会对CD和非乳糜泻性麸质敏感（NCGS）的治疗管理产生积极影响。本综述的目的是探讨FODMAP饮食和低FODMAP饮食（LFD）对CD及麸质相关疾病的潜在影响。
使用PubMed、Medline和Cochrane数据库对与CD、NCGS和GFD相关的FODMAP进行了全面的在线搜索。
事实上，LFD可以成功缓解接受GFD治疗的CD患者的症状。FODMAPs的典型成分果聚糖与NCGS的消化症状有关，LFD可以改善临床表现。根据一些证据，LFD还可以改善采用GFD的乳糜泻患者和NCGS患者的心理状态。然而，LFD对肠道微生物群不应有显著影响。
最近的证据支持限制FODMAP对GFD治疗后仍有持续症状的CD患者以及减轻NCGS胃肠道紊乱的作用，尽管GFD仍然是一线治疗方法。
