Clin Gastroenterology H:在肠易激综合征患者中使用低 FODMAP 饮食可以改善排便情况

2022-01-19 MedSci原创 MedSci原创

肠易激综合征(irritable bowel syndrome,IBS)是一组持续或间歇发作,以腹痛、腹胀、排便习惯和(或)大便性状改变为临床表现,而缺乏胃肠道结构和生化异常的肠道功能紊乱性疾病。

有研究显示低FODMAPs饮食可减少肠易激综合征(IBS)患者的胃肠道症状,可以降低约50-70%左右患者的腹部不适。但是这种饮食模式可能会减少纤维素摄入量,这可能会影响肠道健康并加剧便秘,同时也会改变结肠微生物群的组成。在低FODMAP饮食中同时补充特定类型的膳食纤维,可能对减轻这些潜在风险。甘蔗渣,是一种微发酵的膨化纤维。特别是对于恢复肠道习惯的紊乱有着独特的疗效。本试验旨在研究在低 FODMAP 饮食的同时补充特定纤维对有症状 IBS 患者相关临床和生理指标的影响。

 

研究人员对此进行了一项双盲试验, 26名 IBS 患者被随机分配到 3 种不同的总纤维含量的 FODMAP 饮食组,分别是对照组:23 g/d;微发酵甘蔗渣组: 33 g/d;或纤维组合(甘蔗渣与抗性淀粉)组:45 g/d。每次饮食持续 14 天,试验间隔≥21 天。在基线和饮食干预期间评估患者的临床症状。

 

从基线时的中位 IBS 严重程度评分系统总分 305 分来看,所有饮食都将中位得分降低了 >50分,而饮食之间的症状反应率没有差异:对照 (57%)、甘蔗渣 (67%)、纤维组合 ( 48%) ( P = .459)。补充纤维的饮食与对照饮食相比,排便量高出50%(P < .001)。虽然在粪便特征、描述和含水量或胃肠道转运时间方面没有总体差异,但补充甘蔗渣可使对照饮食期间粪便含水量低和结肠转运缓慢正常化。

 

本项研究证实在开始低 FODMAP饮食期间同时补充纤维不会改变 IBS 患者的症状反应,但会增加粪便体积,并使粪便含水量低和运输缓慢正常化。与单独的甘蔗渣相比,抗性淀粉没有表现出额外的益处。

原始出处:

Daniel So. Et al. Supplementing Dietary Fibers With a Low-FODMAP Diet in Irritable Bowel Syndrome: A Randomized Controlled Crossover Trial. Clinical Gastroenterology and Hepatology.2022.

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    2022-06-05 kkunny
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    2022-03-14 许安
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