低发酵饮食缓解肠易激综合征腹胀的作用机制研究进展

Research progress on the mechanism of low fermentable diet for improving bloating in irritable bowel syndrome

肠易激综合征(irritable bowel syndrome,IBS)是一种功能性肠病,表现为反复发作的腹痛,与排便相关或伴随排便习惯改变,并常有腹胀/腹部膨胀症状。IBS全球患病率逐年升高,导致患者严重身心不适,并造成卫生经济资源浪费。多项研究显示限制可发酵的低聚糖、二糖、单糖和多元醇(统称FODMAPs)摄入可明显缓解IBS相关症状,尤其是腹胀,但对其生理机制和临床效果的研究仍较少。通过分析归纳近年相关临床与基础研究,笔者发现低发酵饮食有助于减少肠腔内容物蓄积、维护肠道微环境稳态、提高循环5-羟色胺水平等,这些均可能是缓解IBS腹胀症状的关键性因素。本文将对此进行综述,为低发酵饮食的进一步临床应用提供依据。

Irritable bowel syndrome(IBS)is a kind of functional bowel disorder characterized by recurrent abdominal pain,which associated with or accompanied by changes in bowel habits and the symptoms of bloating/abdominal distension often.The global prevalence of IBS is increasing year by year,resulting in severe physical and mental discomfort of patients and a waste of health economic resources.Several studies have shown that limiting intake of fermentable oligosaccharides,disaccharides,monosaccharides,and polyols(known as FODMAPs)significantly reduces IBS related symptoms,especially bloating,but there are still few studies on its physiological mechanisms and clinical effects.Through the analysis and summary of recent relevant clinical and basic studies,it was found that low fermentable diet can help reduce intestinal content accumulation,maintain the lumen microenvironment steady and improve the level of circulation 5-hydroxytryptamine level,etc.,which may be the key factor to release the symptoms of IBS abdominal bloating.In this paper,we will give a summary to provide the basis for further clinical application.