Abnormal colonic fermentation in irritable bowel syndrome
Abnormal colonic fermentation in irritable bowel syndrome
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DOI：
10.1016/s0140-6736(98)02146-1
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发表时间：
1998-10-10
期刊：
影响因子：
168.9
通讯作者：
Hunter, JO
中科院分区：
文献类型：
--
作者：
King, TS;Elia, M;Hunter, JO
背景肠易激综合征（IBS）的病因尚不清楚。它可能发生在胃肠炎之后，并与异常的肠道植物群和食物不耐受有关。我们的研究旨在评估这些因素是否与结肠malfermentation.Methods我们进行了交叉对照试验的标准饮食和排除饮食匹配的大量营养素在6名女性IBS患者和6名女性对照。在每种饮食的最后72小时内，测量脂肪，氮，淀粉和非淀粉多糖NSP的粪便排泄量，并在特制的1.4 m（3）全身热量计中收集24小时内的氢和甲烷总排泄量。呼吸氢和甲烷的排泄量，然后测量3小时后，20克口服lactulose.Findings气体排泄的最大速率是显着大于患者比对照组（2.4毫升/分钟IQR 1.7-2.6与0.6，0.4-1.1）。尽管患者的总气体产生量不高于对照组（中位数527 mL/24 h IQR 387-660 vs 412，234-507），但氢气产生量较高（332，318-478 vs 162，126-217，p=0.009）。在患者中，排除饮食减轻了症状，并使最大气体排泄量下降（0.5 mL/min IQR 0.3-0.7）。乳果糖后，呼吸氢是更大的标准比排除diet.Interpretation结肠气体生产，特别是氢，是更大的IBS患者比对照组，和症状和气体生产减少了排除饮食。这种减少可能与耗氢细菌活性的改变有关。发酵可能是IBS发病的一个重要因素。
Background The cause of irritable bowel syndrome (IBS) is unknown. It may follow gastroenteritis and be associated with an abnormal gut flora and with food intolerance. Our study was designed to assess whether these factors were associated with colonic malfermentation.Methods We carried out a crossover controlled trial of a standard diet and an exclusion diet matched for macronutrients in six female IBS patients and six female controls. During the final 72 h on each diet, faecal excretion of fat, nitrogen, starch, and non-starch polysaccharide NSP was measured, and total excretion of hydrogen and methane collected over 24 h in a purpose-built 1.4 m(3) whole-body calorimeter. Breath hydrogen and methane excretion were then measured for 3 h after 20 g oral lactulose.Findings The maximum rate of gas excretion was significantly greater in patients than in controls (2.4 mL/min IQR 1.7-2.6 vs 0.6, 0.4-1.1). Although total gas production in patients was not greater than in controls (median 527 mL/24 h IQR 387-660 vs 412, 234-507), hydrogen production was higher (332, 318-478 vs 162, 126-217, p=0.009). In patients, the exclusion diet reduced symptoms and produced a fall in maximum gas excretion (0.5 mL/min IQR 0.3-0.7). After lactulose, breath hydrogen was greater on the standard than on the exclusion diet.Interpretation Colonic-gas production, particularly of hydrogen, is greater in patients with IBS than in controls, and both symptoms and gas production are reduced by an exclusion diet. This reduction may be associated with alterations in the activity of hydrogen-consuming bacteria. Fermentation may be an important factor in the pathogenesis of IBS.