A Low-FODMAP Diet Provides Benefits for Functional Gastrointestinal Symptoms but Not for Improving Stool Consistency and Mucosal Inflammation in IBD: A Systematic Review and Meta-Analysis.
A Low-FODMAP Diet Provides Benefits for Functional Gastrointestinal Symptoms but Not for Improving Stool Consistency and Mucosal Inflammation in IBD: A Systematic Review and Meta-Analysis.
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低FODMAP饮食有益于IBD患者的功能性胃肠道症状，但不能改善IBD患者的粪便粘稠度和粘膜炎症：一项系统性综述和荟萃分析
DOI：
10.3390/nu14102072
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发表时间：
2022-05-15
期刊：
影响因子：
5.9
通讯作者：
Liu, Xiaowei
中科院分区：
文献类型：
--
作者：
Peng, Ziheng;Yi, Jun;Liu, Xiaowei
关键词：
背景资料：低发酵性低聚糖、二糖、单糖和多元醇饮食（LFD）据称可改善功能性胃肠道症状（FGS）。然而，LFD在伴有FGS的炎症性肠病（IBD）患者中的作用仍不清楚。目的：系统评价LFD治疗炎症性肠病（IBD）伴发FGS的疗效。方法：检索了从成立到2022年1月1日的6个数据库。数据综合为症状改善和粪便硬度正常的相对风险、布里斯托粪便形态量表（BSFS）、IBD简明问卷（SIBDQ）、IBS生活质量（IBS-QoL）、Harvey-Bradshaw指数（HBi）、马约评分和粪便钙卫蛋白（FC）的平均差异。根据研究类型评估偏倚风险。采用漏斗图和Egger检验分析发表偏倚。结果如下：该综述筛选并纳入了9项合格的研究，包括4项随机对照试验（RCT）和5项前后研究，共涉及446名参与者（351名LFD患者与95名对照）。LFD缓解了总体FGS（RR：0.47，95%CI：0.33-0.66，p = 0.0000），获得了较高的SIBDQ评分（MD = 11.24，95%CI 6.61至15.87，p = 0.0000）和较低的克罗恩病HBi评分（MD =-1.09，95%CI-1.77至-0.42，p = 0.002）。然而，正常粪便稠度、BSFS、IBS-QoL、溃疡性结肠炎的马约评分和FC无统计学显著差异。无出版偏倚被发现。结论：LFD提供了一个好处，在FGS和生活质量，但没有改善IBD患者的粪便一致性和粘膜炎症。需要进一步设计良好的RCT来开发IBD的最佳LFD策略。
Background: A low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet (LFD) is claimed to improve functional gastrointestinal symptoms (FGSs). However, the role of LFD in inflammatory bowel disease (IBD) patients with FGSs remains unclear. Objective: To systematically assess the efficacy of LFD in IBD patients with FGSs. Methods: Six databases were searched from inception to 1 January 2022. Data were synthesized as the relative risk of symptoms improvement and normal stool consistency, mean difference of Bristol Stool Form Scale (BSFS), Short IBD Questionnaire (SIBDQ), IBS Quality of Life (IBS-QoL), Harvey-Bradshaw index (HBi), Mayo score, and fecal calprotectin (FC). Risk of bias was assessed based on study types. A funnel plot and Egger’s test were used to analyze publication bias. Results: This review screened and included nine eligible studies, including four randomized controlled trials (RCTs) and five before–after studies, involving a total of 446 participants (351 patients with LFD vs. 95 controls). LFD alleviated overall FGSs (RR: 0.47, 95% CI: 0.33–0.66, p = 0.0000) and obtained higher SIBDQ scores (MD = 11.24, 95% CI 6.61 to 15.87, p = 0.0000) and lower HBi score of Crohn’s disease (MD = −1.09, 95% CI −1.77 to −0.42, p = 0.002). However, there were no statistically significant differences in normal stool consistency, BSFS, IBS-QoL, Mayo score of ulcerative colitis, and FC. No publication bias was found. Conclusions: LFD provides a benefit in FGSs and QoL but not for improving stool consistency and mucosal inflammation in IBD patients. Further well-designed RCTs are needed to develop the optimal LFD strategy for IBD.
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影响因子：
5.9
作者：
Grammatikopoulou MG;Goulis DG;Gkiouras K;Nigdelis MP;Papageorgiou ST;Papamitsou T;Forbes A;Bogdanos DP
通讯作者：
Bogdanos DP
影响因子：
3.6
作者：
Halmos EP;Christophersen CT;Bird AR;Shepherd SJ;Muir JG;Gibson PR
通讯作者：
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影响因子：
9.8
作者：
Drossman, Douglas;Morris, Carolyn B.;Bangdiwala, Shrikant I.
通讯作者：
Bangdiwala, Shrikant I.
影响因子：
4.3
作者：
Chiba, Mitsuro;Abe, Toru;Imai, Hideo
通讯作者：
Imai, Hideo
影响因子：
12.6
作者：
Fritsch, Julia;Garces, Luis;Abreu, Maria T.
通讯作者：
Abreu, Maria T.