AIM To investigate the long-term effect of dietary education on a low fermentable oligosaccharide, disaccharide and polyol(FODMAP) diet on irritable bowel syndrome(IBS) symptoms and quality of life(Qo L).METHODS Parti...AIM To investigate the long-term effect of dietary education on a low fermentable oligosaccharide, disaccharide and polyol(FODMAP) diet on irritable bowel syndrome(IBS) symptoms and quality of life(Qo L).METHODS Participants with IBS(Rome III) were randomized to two groups. Group I commenced a low FODMAP diet at baseline. At three months, group II, so far a comparator group, crossed over to a low FODMAP diet while group I started re-challenging foods. All patients completed the IBS SSS(IBS symptom severity scoring system, 0-500 points increasing with severity), IBS Qo L questionnaire(0-100 increasing with Qo L), a FODMAP specific food frequency questionnaire and provided a stool sample at baseline, three and six months for microbiome analysis.RESULTS Fifty participants were enrolled into group I(n = 23) or group II(n = 27). Participants in both groups were similar in baseline values but with more men in group I. There was a significantly lower IBS SSS(275.6 ± 63.6 to 128.8 ± 82.5 vs 246.8 ± 71.1 to 203.6 ± 70.1)(P < 0.0002) and increased Qo L(68.5 ± 18.0 to 83 ± 13.4 vs 72.9 ± 12.8 to 73.3 ± 14.4)(P < 0.0001) in group I vs group II at 3 mo. The reduced IBS SSS was sustained at 6 mo in group I(160 ± 102) and replicated in group II(124 ± 76). Fiber intake decreased on the low FODMAP diet(33 ± 17 g/d to 21 ± 8 g/d)(P < 0.01) and after re-introducing FODMAP containing foods increased again to 27 ± 9 g/d. There was no change seen in the intestinal microbiome when participants adopted a low FODMAP diet.CONCLUSION This study demonstrated that a reduction in FODMAPs improves symptoms in IBS and this improvement can be maintained while reintroducing FODMAPs.展开更多
Coeliac Disease (CD) is a permanent gluten intolerance, whose pathogenesis involves multiple factors including genetics and environment. CD has different representations and non-specific symptoms such as diarrhea, blo...Coeliac Disease (CD) is a permanent gluten intolerance, whose pathogenesis involves multiple factors including genetics and environment. CD has different representations and non-specific symptoms such as diarrhea, bloating, pain, flatulence and constipation may sometimes be misleading. Once diagnosed of CD, patients must adhere to Gluten Free Diet, which consists in the lifelong avoidance of gluten containing foods and of those naturally gluten free but at risk of contamination. This dietary approach is considered the only therapy in order to avoid symptoms exacerbation and to reduce the digestive mucosa inflammation, which has been related to higher risks of lymphoproliferative malignancy and other immunological disorders. However, being on a Gluten Free Diet is not as resolving as it may seem since it has several criticalities. First of all, excluding gluten means limiting food variety so that coeliac patients may have unbalanced intake of several nutrients and develop clinical or subclinical deficiencies. This can be due to scarce attention to qualitative and quantitative composition of diets and poor information about gluten-containing foods, which only patient-tailored dietetic protocol and long-term follow-up can achieve. Secondly, Gluten Free Diet may not result in complete remission of mucosal damage or in resolution of symptoms. Unintentional contamination of gluten or poor adherence to diet are the main culprits of the incomplete mucosal healing but other triggers may be involved. Recent research has focused on the role of FODMAPs in changing gut microbiota and on the improvement of Irritable Bowel Syndrome (IBS) symptoms after their dietary avoidance or reduction. Since CD and IBS may share many clinical presentations, further studies are needed to evaluate if a subgroup of CD patients whose symptoms are not improved by Gluten Free Diet could benefit from a new therapeutic approach consisting in both gluten/wheat and FODMAPs avoidance.展开更多
文摘AIM To investigate the long-term effect of dietary education on a low fermentable oligosaccharide, disaccharide and polyol(FODMAP) diet on irritable bowel syndrome(IBS) symptoms and quality of life(Qo L).METHODS Participants with IBS(Rome III) were randomized to two groups. Group I commenced a low FODMAP diet at baseline. At three months, group II, so far a comparator group, crossed over to a low FODMAP diet while group I started re-challenging foods. All patients completed the IBS SSS(IBS symptom severity scoring system, 0-500 points increasing with severity), IBS Qo L questionnaire(0-100 increasing with Qo L), a FODMAP specific food frequency questionnaire and provided a stool sample at baseline, three and six months for microbiome analysis.RESULTS Fifty participants were enrolled into group I(n = 23) or group II(n = 27). Participants in both groups were similar in baseline values but with more men in group I. There was a significantly lower IBS SSS(275.6 ± 63.6 to 128.8 ± 82.5 vs 246.8 ± 71.1 to 203.6 ± 70.1)(P < 0.0002) and increased Qo L(68.5 ± 18.0 to 83 ± 13.4 vs 72.9 ± 12.8 to 73.3 ± 14.4)(P < 0.0001) in group I vs group II at 3 mo. The reduced IBS SSS was sustained at 6 mo in group I(160 ± 102) and replicated in group II(124 ± 76). Fiber intake decreased on the low FODMAP diet(33 ± 17 g/d to 21 ± 8 g/d)(P < 0.01) and after re-introducing FODMAP containing foods increased again to 27 ± 9 g/d. There was no change seen in the intestinal microbiome when participants adopted a low FODMAP diet.CONCLUSION This study demonstrated that a reduction in FODMAPs improves symptoms in IBS and this improvement can be maintained while reintroducing FODMAPs.
文摘目的分析对肠易激综合征(Irritable Bowel Syndrome,IBS)患者用低可发酵的单糖、双糖、低聚糖和多元醇等饮食干预对胃肠道症状的影响。方法将2020年8月-2021年12月接收治疗的IBS患者78例作为观察对象,按照随机数字表法分为观察组(低FODMAP饮食)和对照组(常规饮食指导),比较两组分别干预后的病情严重程度调查表(Severity severity questionnaire,IBS-SSS)、日常生活能力量表(Activity of Daily Living Scale,ADL)、胃肠道症状改善时间(腹痛、腹泻、排便改变)。结果两组干预前的IBS-SSS比较并无统计学意义(P>0.05),干预后,观察组IBS-SSS评分(53.69±12.15)分相较对照组(85.45±11.12)分更低,对比有统计学意义(P<0.05),干预后,观察组胃肠症状改善时间包括排便(2.62±0.23)周、腹痛(1.72±0.23)周、腹泻(2.41±0.23)周时间更短,对比有统计学意义(P<0.05),两组干预前的ADL评分比较并无差异,无统计学意义(P>0.05),干预后,观察组ADL评分更高,对比有统计学意义(P<0.05)。结论低FODMAP饮食对IBS患者可缩短患者胃肠道症状改善时间,提高患者日常生活质量,减轻患者病情严重程度。
文摘Coeliac Disease (CD) is a permanent gluten intolerance, whose pathogenesis involves multiple factors including genetics and environment. CD has different representations and non-specific symptoms such as diarrhea, bloating, pain, flatulence and constipation may sometimes be misleading. Once diagnosed of CD, patients must adhere to Gluten Free Diet, which consists in the lifelong avoidance of gluten containing foods and of those naturally gluten free but at risk of contamination. This dietary approach is considered the only therapy in order to avoid symptoms exacerbation and to reduce the digestive mucosa inflammation, which has been related to higher risks of lymphoproliferative malignancy and other immunological disorders. However, being on a Gluten Free Diet is not as resolving as it may seem since it has several criticalities. First of all, excluding gluten means limiting food variety so that coeliac patients may have unbalanced intake of several nutrients and develop clinical or subclinical deficiencies. This can be due to scarce attention to qualitative and quantitative composition of diets and poor information about gluten-containing foods, which only patient-tailored dietetic protocol and long-term follow-up can achieve. Secondly, Gluten Free Diet may not result in complete remission of mucosal damage or in resolution of symptoms. Unintentional contamination of gluten or poor adherence to diet are the main culprits of the incomplete mucosal healing but other triggers may be involved. Recent research has focused on the role of FODMAPs in changing gut microbiota and on the improvement of Irritable Bowel Syndrome (IBS) symptoms after their dietary avoidance or reduction. Since CD and IBS may share many clinical presentations, further studies are needed to evaluate if a subgroup of CD patients whose symptoms are not improved by Gluten Free Diet could benefit from a new therapeutic approach consisting in both gluten/wheat and FODMAPs avoidance.
