Effects of olestra and sorbitol consumption on objective measures of diarrhea: impact of stool viscosity on common gastrointestinal symptoms.
Effects of olestra and sorbitol consumption on objective measures of diarrhea: impact of stool viscosity on common gastrointestinal symptoms.
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食用橄榄油和山梨糖醇对腹泻客观指标的影响：粪便粘度对常见胃肠道症状的影响。
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发表时间：
2000
期刊：
影响因子：
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通讯作者：
R. Giannella
中科院分区：
文献类型：
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作者：
J. Mcrorie;N. Zorich;K. A. Riccardi;Lori J. Bishop;T. Filloon;S. Wason;R. Giannella
本研究的目的是确定食用奥利斯特拉和山梨醇对腹泻的三种公认客观指标（粪便排出量>250 g/天，液体/水样便，排便频率>3次/天）的影响，以及粪便成分如何影响常见胃肠道症状的报告。一项双盲、安慰剂对照研究比较了山梨糖醇（40 g/天，糖果中）（一种吸收不良的糖醇，具有已知的渗透作用）与olestra（20或40 g/天，薯片中）（一种非吸收性脂肪）对粪便成分和GI症状的客观测量结果的影响。66例受试者在代谢病房居住12天：导入期2天，基线期4天，治疗期6天。山梨醇40 g/天导致摄入后1-3小时内出现稀便/液状便。相比之下，olestra在食用2-4天后产生剂量反应性粪便软化作用。当平均粪便表观粘度（峰值力（PF），g）从感知的“正常”（平均值+/- SE，1355 +/- 224 g PF;硬便）降至稀便（260 +/- 68 g PF）时，受试者报告“腹泻”。治疗期间粪便的平均表观粘度：安慰剂，1363 +/- 280 g（硬）; olestra 20 g/天，743 +/- 65 g（软）; olestra 40 g/天，563 +/- 105 g（软）;山梨醇40 g/天，249 +/- 53 g（松散）。在采集的1098份粪便样本中，38%（419/1098）被受试者评定为“腹泻”，但只有2%的治疗日（均在山梨醇治疗组）符合临床腹泻的公认标准。与安慰剂相比，山梨醇（而非olestra）增加了腹部绞痛、尿急和恶心的严重程度。Olestra的摄入量远远超过正常的零食摄入量，在摄入数天后导致粪便逐渐软化，不符合腹泻的三个客观指标中的任何一个，也不增加GI症状。山梨醇的消耗量仅为需要“通便作用”信息标签的剂量的80%，导致快速发作的稀便/液体便以及腹部绞痛、尿急和恶心的显著增加。总体而言，受试者在粪便从其感知的“正常”下降时将粪便归类为“腹泻”，但这些报告中的绝大多数与临床显著腹泻无关。
The aim of this study was to determine the effects of olestra and sorbitol consumption on three accepted objective measures of diarrhea (stool output >250 g/day, liquid/watery stools, bowel movement frequency >3/day), and how stool composition influences reports of common gastrointestinal symptoms. A double-blind, placebo-controlled study compared the effects of sorbitol (40 g/day in candy), a poorly absorbed sugar-alcohol with known osmotic effects, with those of olestra (20 or 40 g/day in potato chips), a nonabsorbed fat, on objective measures of stool composition and GI symptoms. Sixty-six subjects resided on a metabolic ward for 12 days: 2 days lead-in, 4 days baseline, 6 days treatment. Sorbitol 40 g/day resulted in loose/liquid stools within 1-3 h of consumption. In contrast, olestra resulted in a dose-responsive stool softening effect after 2-4 days of consumption. Subjects reported "diarrhea" when mean stool apparent viscosity (peak force (PF), g) decreased from a perceived "normal" (mean +/- SE, 1355 +/- 224 g PF; firm stool) to loose (260 +/- 68 g PF) stool. Mean apparent viscosity of stool during treatment: placebo, 1363 +/- 280 g (firm); olestra 20 g/day 743 +/- 65 g (soft); olestra 40 g/day, 563 +/- 105 g (soft); and sorbitol 40 g/day, 249 +/- 53 g (loose). Of the 1098 stool samples collected, 38% (419/1098) were rated by subjects as "diarrhea," yet only 2% of treatment days (all in the sorbitol treatment group) met commonly accepted criteria for a clinical diarrhea. Sorbitol, but not olestra, increased the severity of abdominal cramping, urgency and nausea compared to placebo. Olestra consumption, at levels far in excess of normal snacking conditions, resulted in a gradual stool softening effect after several days of consumption, did not meet any of the three objective measures of diarrhea, and did not increase GI symptoms. Sorbitol consumption, at only 80% of the dose requiring a "laxative effect" information label, resulted in rapid onset loose/liquid stools and a significant increase in abdominal cramping, urgency and nausea. Overall, subjects categorized stool as "diarrhea" when stool decreased from their perceived "normal," but the vast majority of these reports were not associated with clinically significant diarrhea.