Pueschel Lea, Nothacker Sonja, Kuhn Leonie, Wedemeyer Heiner, Lenzen Henrike, Wiestler Miriam
Department of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology, Hannover Medical School, 30625 Hannover, Germany.
School for Dietitians, Hannover Medical School, 30625 Hannover, Germany.
J Clin Med. 2024 Dec 29;14(1):137. doi: 10.3390/jcm14010137.
: Inflammatory bowel disease (IBD) affects gastrointestinal function and may alter fecal and flatulence odor (intestinal odor) due to changes in inflammation, the gut microbiome, and metabolism. Investigating the relationship between dietary habits and intestinal odor in IBD is critical given the relationship between diet, gut health, and microbiome diversity. : We performed a cohort analysis of a monocentric, cross-sectional study at a tertiary referral center and compared the perception of fecal and flatulence odor in 233 IBD patients (n = 117 women) with that of 96 healthy controls (HCs) (n = 67 women). In addition to a short screening questionnaire on highly processed foods (sQ-HPF), dietary behavior (Food Frequency Questionnaire (FFQ)), clinical (HBI, PMS) and biochemical (CRP, fecal calprotectin) parameters of disease activity, and adherence to a Mediterranean diet were assessed. : A notable predisposition towards elevated levels of intestinal malodor was identified in the IBD cohort when compared to the HC group. The analysis of dietary behavior in conjunction with intestinal malodor revealed more pronounced associations in the HC collective than in the IBD collective. The data further indicated that, in comparison to those in remission, IBD individuals with an active disease status exhibited a higher prevalence of intestinal malodor. In an adjusted logistic regression analysis of the influence of disease- and diet-specific factors on flatulence and fecal malodor in IBD, male sex was identified as a significant risk factor. : This study highlights the significance of dietary factors in the management of IBD symptoms, with a particular focus on flatulence and fecal odor. Individuals with IBD demonstrated a higher propensity for intestinal malodor compared to HC, with active disease status further amplifying this prevalence. Dietary behavior showed stronger associations with malodor in the HC group than in IBD individuals, suggesting distinct interaction patterns between diet and gut health in these populations.
炎症性肠病（IBD）会影响胃肠功能，并且可能由于炎症、肠道微生物群和新陈代谢的变化而改变粪便和肠胃胀气的气味（肠道气味）。鉴于饮食、肠道健康和微生物群多样性之间的关系，研究IBD患者的饮食习惯与肠道气味之间的关系至关重要。我们在一家三级转诊中心进行了一项单中心横断面研究的队列分析，比较了233例IBD患者（117例女性）和96例健康对照者（HCs，67例女性）对粪便和肠胃胀气气味的感知。除了一份关于高加工食品的简短筛查问卷（sQ-HPF）外，还评估了饮食行为（食物频率问卷（FFQ））、疾病活动的临床（HBI、PMS）和生化（CRP、粪便钙卫蛋白）参数以及对地中海饮食的依从性。与HC组相比，IBD队列中明显存在肠道恶臭水平升高的倾向。结合肠道恶臭对饮食行为的分析显示，HC人群中的关联比IBD人群中更为明显。数据进一步表明，与缓解期患者相比，处于疾病活动状态的IBD患者肠道恶臭的患病率更高。在一项关于疾病和饮食特定因素对IBD患者肠胃胀气和粪便恶臭影响的校正逻辑回归分析中，男性被确定为一个重要的风险因素。这项研究强调了饮食因素在IBD症状管理中的重要性, 尤其关注肠胃胀气和粪便气味。与HC相比，IBD患者表现出更高的肠道恶臭倾向，疾病活动状态进一步加剧了这种患病率。饮食行为在HC组中与恶臭的关联比在IBD个体中更强，这表明这些人群中饮食与肠道健康之间存在不同的相互作用模式。
