Varney Jane E, So Daniel, Gibson Peter R, Rhys-Jones Dakota, Lee Yuet Sang Jimmy, Fisher Jane, Moore Judith S, Ratner Roni, Morrison Mark, Burgell Rebecca E, Muir Jane G
Department of Gastroenterology, School of Translational Medicine, Monash University and Alfred Health, Melbourne, Victoria, Australia.
Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Aliment Pharmacol Ther. 2025 Jun;61(12):1889-1903. doi: 10.1111/apt.70161. Epub 2025 May 4.
Gastrointestinal symptoms affect most women with endometriosis, but therapeutic interventions are poorly defined.
To compare the effects of a 28-day low fermentable oligo-, di- and mono-saccharides and polyols (FODMAP) or control diet on gastrointestinal symptom severity in individuals with endometriosis and poorly controlled gastrointestinal symptoms.
In this single-blinded randomised, controlled cross-over feeding trial, we randomised women aged ≥ 18 years to 28 days of either a low FODMAP (< 5 g/day FODMAPs) or control diet (20 g/day FODMAPs), both modelled on Australian Dietary Guidelines, before a ≥ 28-day washout and crossover to the alternate diet. The primary outcome was the proportion of responders defined according to the response in overall gastrointestinal symptoms on a 100-mm visual analogue scale. Secondary outcomes included gastrointestinal symptoms, quality of life and psychological status.
Of 35 women randomised (mean age 31; 95% confidence interval 29, 33 years), 21 (60%) responded to the low FODMAP diet compared with 9 (26%) to the control diet (p = 0.008). In the 4th week of the dietary intervention, overall symptom scores were 35 (21, 42) mm on the low FODMAP diet and 58 (55, 65) mm on the control diet (p < 0.001). Abdominal pain, bloating, stool form and quality of life for both gastrointestinal and endometriosis-associated scales were significantly better for the low FODMAP diet compared with the control diet, but not overall for perceived stress, anxiety or depression.
The low FODMAP diet ameliorates gastrointestinal symptoms related to endometriosis and improves quality of life. Confirmation of these findings in a real-world setting is required.
The trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12621000153819).
胃肠道症状影响大多数子宫内膜异位症女性，但治疗干预措施尚不明确。
比较28天低可发酵寡糖、双糖、单糖和多元醇（FODMAP）饮食或对照饮食对子宫内膜异位症且胃肠道症状控制不佳者胃肠道症状严重程度的影响。
在这项单盲随机对照交叉喂养试验中，我们将年龄≥18岁的女性随机分为两组，一组接受28天低FODMAP饮食（每日FODMAP含量<5克），另一组接受对照饮食（每日FODMAP含量20克），两种饮食均参照澳大利亚饮食指南制定，经过≥28天的洗脱期后交叉至另一种饮食。主要结局是根据100毫米视觉模拟量表上总体胃肠道症状的反应定义的反应者比例。次要结局包括胃肠道症状、生活质量和心理状态。
35名随机分组的女性（平均年龄31岁；95%置信区间29，33岁）中，21名（60%）对低FODMAP饮食有反应，而对照饮食组为9名（26%）（p = 0.008）。在饮食干预的第4周，低FODMAP饮食组的总体症状评分为35（21，42）毫米，对照饮食组为58（55，65）毫米（p < 0.001）。与对照饮食相比，低FODMAP饮食在腹痛、腹胀、大便形态以及胃肠道和子宫内膜异位症相关量表的生活质量方面均有显著改善，但在感知压力、焦虑或抑郁方面总体无改善。
低FODMAP饮食可改善与子宫内膜异位症相关的胃肠道症状并提高生活质量。需要在实际环境中对这些发现进行验证。
该试验已在澳大利亚新西兰临床试验注册中心注册（ACTRN12621000153819）。
