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饮食干预对小儿胃食管反流病的管理效果:一项全面的系统评价。

Effectiveness of dietary interventions in managing pediatric gastroesophageal reflux disease: a comprehensive systematic review.

作者信息

Alnaim Abdulrahman A

机构信息

Department of Pediatrics, College of Medicine, King Faisal University, Al-Ahsaa, Saudi Arabia.

出版信息

Eur J Med Res. 2025 Jul 2;30(1):549. doi: 10.1186/s40001-025-02784-0.


DOI:10.1186/s40001-025-02784-0
PMID:40604920
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12219262/
Abstract

BACKGROUND: Pediatric gastroesophageal reflux disease (GERD) is a common chronic digestive disorder that significantly impacts children's growth, development, and quality of life. Traditional management of GERD often involves pharmacological interventions, such as proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs), which raise concerns about side effects and long-term safety. Recently, interest has shifted toward dietary interventions as complementary or alternative approaches to managing GERD symptoms. OBJECTIVE: This systematic review aims to evaluate the efficacy of various dietary interventions, including low-fat diets, plant-based diets, exclusion diets, and nutraceuticals such as probiotics, in managing pediatric GERD symptoms and promoting overall digestive health. METHODS: A comprehensive search was conducted across PubMed, MEDLINE (Ovid), Embase, Web of Science, and Cochrane databases up to March 2024. Studies investigating dietary interventions for pediatric GERD published in English were selected. Risk of bias was assessed using the modified ROBVIS2 tool, and results were synthesized through narrative and thematic analysis. RESULTS: Eleven studies were included in the review. Evidence on low-fat versus full-fat dairy diets showed mixed results, with no clear consensus on their impact on GERD symptoms. Plant-based and exclusion diets demonstrated significant improvements in GERD symptoms, likely due to their anti-inflammatory properties and the elimination of dietary triggers. Probiotics emerged as a promising intervention, reducing GERD symptoms by enhancing gut barrier function and modulating inflammation. However, the studies varied in design, and adherence to dietary interventions was identified as a key challenge, particularly in pediatric populations. CONCLUSION: Although current evidence remains limited, this review highlights promising dietary strategies-especially plant-based diets and probiotics-for managing pediatric GERD. Future research should focus on personalized nutrition and long-term effectiveness to validate these non-pharmacological interventions.

摘要

背景:小儿胃食管反流病(GERD)是一种常见的慢性消化系统疾病,对儿童的生长、发育和生活质量有显著影响。GERD的传统治疗通常涉及药物干预,如质子泵抑制剂(PPIs)和组胺-2受体拮抗剂(H2RAs),这引发了对副作用和长期安全性的担忧。最近,人们的兴趣已转向饮食干预,将其作为管理GERD症状的补充或替代方法。 目的:本系统评价旨在评估各种饮食干预措施的疗效,包括低脂饮食、植物性饮食、排除饮食以及益生菌等营养补充剂,以管理小儿GERD症状并促进整体消化健康。 方法:截至2024年3月,对PubMed、MEDLINE(Ovid)、Embase、Web of Science和Cochrane数据库进行了全面检索。选择以英文发表的关于小儿GERD饮食干预的研究。使用改良的ROBVIS2工具评估偏倚风险,并通过叙述性和主题分析对结果进行综合。 结果:该评价纳入了11项研究。关于低脂与全脂乳制品饮食的证据结果不一,对其对GERD症状的影响尚无明确共识。植物性饮食和排除饮食在GERD症状方面有显著改善,可能是由于它们的抗炎特性以及消除了饮食触发因素。益生菌作为一种有前景的干预措施出现,通过增强肠道屏障功能和调节炎症来减轻GERD症状。然而,研究设计各不相同,并且确定坚持饮食干预是一个关键挑战,尤其是在儿科人群中。 结论:尽管目前的证据仍然有限,但本评价突出了有前景的饮食策略——特别是植物性饮食和益生菌——用于管理小儿GERD。未来的研究应侧重于个性化营养和长期有效性,以验证这些非药物干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2872/12219262/6261e1d1334d/40001_2025_2784_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2872/12219262/05d0a79d8a8a/40001_2025_2784_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2872/12219262/6261e1d1334d/40001_2025_2784_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2872/12219262/05d0a79d8a8a/40001_2025_2784_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2872/12219262/6261e1d1334d/40001_2025_2784_Fig2_HTML.jpg

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本文引用的文献

[1]
Exploring effects of gut microbiota on tertiary lymphoid structure formation for tumor immunotherapy.

Front Immunol. 2025-3-7

[2]
Perceptions of Resilience Among Nurses: A Qualitative Study Based on the Society-To-Cells Framework.

J Adv Nurs. 2024-12-30

[3]
Role of Nutrition in Gastroesophageal Reflux, Irritable Bowel Syndrome, Celiac Disease, and Inflammatory Bowel Disease.

Gastro Hep Adv. 2023-7-5

[4]
Nutritional Considerations During Major Weight Loss Therapy: Focus on Optimal Protein and a Low-Carbohydrate Dietary Pattern.

Curr Nutr Rep. 2024-9

[5]
Nursing practice of routine gastric aspiration in preterm infants and its link to necrotizing enterocolitis: is the practice still clinically relevant?

BMC Nurs. 2024-5-17

[6]
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Nutrients. 2024-3-9

[7]
Proton Pump Inhibitors in Pediatric Gastroesophageal Reflux Disease: A Systematic Review of Randomized Controlled Trials.

Children (Basel). 2024-3-1

[8]
Causal relationship between gut microbiota and risk of gastroesophageal reflux disease: a genetic correlation and bidirectional Mendelian randomization study.

Front Immunol. 2024

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The Efficacy of Dietary Interventions in Patients with Gastroesophageal Reflux Disease: A Systematic Review and Meta-Analysis of Intervention Studies.

Nutrients. 2024-2-5

[10]
Therapeutic Evaluation of subsp. MH-02 as an Adjunctive Treatment in Patients with Reflux Esophagitis: A Randomized, Double-Blind, Placebo-Controlled Trial.

Nutrients. 2024-1-24

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