A Diet Low in FODMAPs Reduces Symptoms of Irritable Bowel Syndrome
A Diet Low in FODMAPs Reduces Symptoms of Irritable Bowel Syndrome
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DOI：
10.1053/j.gastro.2013.09.046
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发表时间：
2014-01-01
期刊：
影响因子：
29.4
通讯作者：
Muir, Jane G.
中科院分区：
文献类型：
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作者：
Halmos, Emma P.;Power, Victoria A.;Muir, Jane G.
背景与目的：低可发酵低聚糖、二糖、单糖和多元醇（FODMAPs）的饮食常用于治疗肠易激综合征（IBS）患者的功能性胃肠道症状，但与正常的西方饮食相比，其疗效的证据有限。我们在IBS患者中进行了一项随机、对照、单盲、交叉试验，研究了低FODMAPs饮食与澳大利亚饮食的效果。方法：在一项研究中，30例IBS患者和8名健康个体（对照组，人口统计学和饮食匹配），我们收集了受试者1个习惯周的饮食数据。然后，参与者被随机分配到接受21天低FODMAPs饮食或典型澳大利亚饮食的组中，然后是至少21天的洗脱期，然后转换为替代饮食。使用0至100 mm视觉模拟量表对日常症状进行评分。几乎所有的食物都是在干预饮食期间提供的，低FODMAP饮食的目标是每餐摄入少于0.5 g FODMAP。从第17-21天收集所有粪便，并评估频率、重量、含水量和King's Stool Chart评级。研究结果：与澳大利亚饮食（44.9; 95%置信区间，36.6-53.1 mm; P <0.001）和受试者的习惯性饮食相比，患有IBS的受试者在低FODMAPs饮食时的总体胃肠道症状评分较低（22.8; 95%置信区间，16.7-28.8 mm）。当IBS患者采用低FODMAP饮食时，腹胀、疼痛和通风也减少了。在对照组中，症状最小，且未被任何饮食改变。所有IBS亚型的患者在低FODMAP饮食时对粪便稠度的满意度更高，但以大肠杆菌为主的IBS是唯一一种粪便频率和King's Stool Chart评分改变的亚型。结论：在一项IBS患者的对照、交叉研究中，低FODMAPs饮食可有效减少功能性胃肠道症状。这种高质量的证据支持其作为一线治疗的用途。
BACKGROUND & AIMS: A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) often is used to manage functional gastrointestinal symptoms in patients with irritable bowel syndrome (IBS), yet there is limited evidence of its efficacy, compared with a normal Western diet. We investigated the effects of a diet low in FODMAPs compared with an Australian diet, in a randomized, controlled, single-blind, cross-over trial of patients with IBS. METHODS: In a study of 30 patients with IBS and 8 healthy individuals (controls, matched for demographics and diet), we collected dietary data from subjects for 1 habitual week. Participants then randomly were assigned to groups that received 21 days of either a diet low in FODMAPs or a typical Australian diet, followed by a washout period of at least 21 days, before crossing over to the alternate diet. Daily symptoms were rated using a 0- to 100-mm visual analogue scale. Almost all food was provided during the interventional diet periods, with a goal of less than 0.5 g intake of FODMAPs per meal for the low-FODMAP diet. All stools were collected from days 17-21 and assessed for frequency, weight, water content, and King's Stool Chart rating. RESULTS: Subjects with IBS had lower overall gastrointestinal symptom scores (22.8; 95% confidence interval, 16.7-28.8 mm) while on a diet low in FODMAPs, compared with the Australian diet (44.9; 95% confidence interval, 36.6-53.1 mm; P < .001) and the subjects' habitual diet. Bloating, pain, and passage of wind also were reduced while IBS patients were on the low-FODMAP diet. Symptoms were minimal and unaltered by either diet among controls. Patients of all IBS subtypes had greater satisfaction with stool consistency while on the low-FODMAP diet, but diarrhea-predominant IBS was the only subtype with altered fecal frequency and King's Stool Chart scores. CONCLUSIONS: In a controlled, cross-over study of patients with IBS, a diet low in FODMAPs effectively reduced functional gastrointestinal symptoms. This high-quality evidence supports its use as a first-line therapy.