Raja Snigdha, Teitelbaum Jonathan E, Pereira Kimberly, Guli Katelyn, Schosheim Alexander
The Unterberg Children's Hospital Long Branch New Jersey USA.
Division of Pediatric Gastroenterology The Unterberg Children's Hospital Long Branch New Jersey USA.
JPGN Rep. 2025 Jan 16;6(2):75-79. doi: 10.1002/jpr3.12157. eCollection 2025 May.
OBJECTIVES: Disorders of gut-brain interaction (DGBIs), including irritable bowel syndrome (IBS), are common among children. Although a diet that is low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) has been proven to help adults with IBS, there is conflicting evidence of its efficacy in pediatric patients. METHODS: This was a retrospective chart review of pediatric patients with DGBIs diagnosed by a pediatric gastroenterologist between December 2018 and April 2022 and referred to a dietician for low FODMAP diet (LFD). The diagnosis was based on Rome IV criteria, and the chart review was based on International Classification of Diseases 10 diagnosis codes for DGBIs. Subjective historical assessment was used to define symptom improvement. The causative FODMAP Monash group(s) were identified during the reintroduction phase based on a symptom diary. RESULTS: A total of 58 patients were initially identified (38 females), 47 of whom completed the LFD and followed up. This included 24 patients with IBS-diarrhea predominant (IBS-D), 10 patients with IBS-mixed type (IBS-M), 6 patients with IBS-constipation predominant (IBS-C), and 7 patients with functional abdominal pain (FAP) or functional dyspepsia (FD). Symptom improvement occurred in 22 (91.6%) of IBS-D, 7 (70%) of IBS-M, 3 (50%) of IBS-C, and 3 (42.8%) of FAP/FD. Fructans, garlic, onions, and lactose were the most common offenders. CONCLUSION: LFD improves symptoms in most patients with DGBIs, particularly those with IBS-D.
目的:肠道-脑交互障碍(DGBIs),包括肠易激综合征(IBS),在儿童中很常见。尽管低发酵性寡糖、双糖、单糖和多元醇(FODMAP)饮食已被证明有助于成人IBS患者,但关于其对儿科患者疗效的证据存在矛盾。 方法:这是一项对2018年12月至2022年4月间由儿科胃肠病学家诊断为DGBIs并转诊至营养师处接受低FODMAP饮食(LFD)的儿科患者的回顾性病历审查。诊断基于罗马IV标准,病历审查基于国际疾病分类第10版中DGBIs的诊断编码。采用主观病史评估来定义症状改善情况。在重新引入阶段,根据症状日记确定致病的FODMAP类别。 结果:最初共识别出58例患者(38例女性),其中47例完成了LFD并进行了随访。这包括24例腹泻型IBS(IBS-D)患者、10例混合型IBS(IBS-M)患者、6例便秘型IBS(IBS-C)患者以及7例功能性腹痛(FAP)或功能性消化不良(FD)患者。IBS-D患者中有22例(91.6%)症状改善,IBS-M患者中有7例(70%),IBS-C患者中有3例(50%),FAP/FD患者中有3例(42.8%)。果聚糖、大蒜、洋葱和乳糖是最常见的致病因素。 结论:LFD可改善大多数DGBIs患者的症状,尤其是IBS-D患者。
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