特殊饮食在炎症性肠病中的治疗意义

Therapeutic significance of special diets in inflammatory bowel disease

炎症性肠病(inflammatory bowel disease,IBD)日益增加的发病率引起了广泛的关注,但根本原因仍不清楚,主要认为是遗传变异、宿主免疫系统和环境因素之间复杂相互作用的结果。目前认为饮食是IBD发展的危险因素之一,基于饮食的治疗继续受到越来越多的关注,尤其在患者中几种特殊饮食逐渐流行。我们根据现有的临床证据,回顾了几种特殊饮食疗法的特点及在IBD管理中的作用,主要包括了低发酵寡糖、二糖、单糖和多元醇饮食,无麸质饮食,特定碳水化合物饮食和地中海饮食。目前证据并不推荐明确的IBD特殊饮食治疗,还需要更大规模的前瞻性研究。

The increasing incidence of inflammatory bowel disease(IBD)has attracted much attention.However,the underlying cause is still unclear,which is mainly considered to be the result of complex interactions between genetic variation,host immune system and environmental factors.Diet is now considered to be one of the risk factors for the development of IBD.Diet-based therapy continues to receive attention,especially several special diets popular among patients.Based on available clinical evidences,we reviewed the roles of several special diets in the management of IBD,including low-fermentable oligosaccharide,disaccharide,monosaccharide,and polyol diet(low FODMAP diet,LFD),gluten free diet,specific carbohydrate diet and Mediterranean diet.Overall,current evidences do not recommend definite diet therapy for IBD,and larger prospective studies are needed.