AJG:针对IBS的两种饮食干预效果如何?
  • 在肠易激综合征及腹泻(IBS-D)患者中,对比两种饮食干预:低FODMAP饮食,及修改过的NICE指南(mNICE饮食);
  • 84名患者完成了试验(45名采用低FODMAP饮食,39名采用mNICE饮食);
  • 52%的低FODMAP饮食组患者及41%的mNICE饮食组患者报告了IBS-D症状的缓解,两组无显著差异;
  • 低FODMAP饮食组的患者腹痛、腹胀、排便频率等均有更高的缓解率。
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A Randomized Controlled Trial Comparing the Low FODMAP Diet vs. Modified NICE Guidelines in US Adults with IBS-D

在美国肠易激综合征及腹泻患者中通过随机对照试验比较低FODMAP饮食与修改后的NICE指南

10.1038/ajg.2016.434

2016-10-11, Article

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OBJECTIVES: There has been an increasing interest in the role of fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) in irritable bowel syndrome (IBS). We report results from the first randomized controlled trial of the low FODMAP diet in US adults with IBS and diarrhea (IBS-D). The objectives were to compare the efficacy of the low FODMAP diet vs. a diet based upon modified National Institute for Health and Care Excellence guidelines (mNICE) on overall and individual symptoms in IBS-D patients.
METHODS: This was a single-center, randomized-controlled trial of adult patients with IBS-D (Rome III) which compared 2 diet interventions. After a 2-week screening period, eligible patients were randomized to a low FODMAP or mNICE diet for 4 weeks. The primary end point was the proportion of patients reporting adequate relief of IBS-D symptoms ≥50% of intervention weeks 3-4. Secondary outcomes included a composite end point which required response in both abdominal pain (≥30% reduction in mean daily pain score compared with baseline) and stool consistency (decrease in mean daily Bristol Stool Form of ≥1 compared with baseline), abdominal pain and stool consistency responders, and other key individual IBS symptoms assessed using daily questionnaires.
RESULTS: After screening, 92 subjects (65 women, median age 42.6 years) were randomized. Eighty-four patients completed the study (45 low FODMAP, 39 mNICE). Baseline demographics, symptom severity, and nutrient intake were similar between groups. Fifty-two percent of the low FODMAP vs. 41% of the mNICE group reported adequate relief of their IBS-D symptoms (P=0.31). Though there was no significant difference in the proportion of composite end point responders (P=0.13), the low FODMAP diet resulted in a higher proportion of abdominal pain responders compared with the mNICE group (51% vs. 23%, P=0.008). Compared with baseline scores, the low FODMAP diet led to greater reductions in average daily scores of abdominal pain, bloating, consistency, frequency, and urgency than the mNICE diet.
CONCLUSIONS: In this US trial, 40-50% of patients reported adequate relief of their IBS-D symptoms with the low FODMAP diet or a diet based on modified NICE guidelines. The low FODMAP diet led to significantly greater improvement in individual IBS symptoms, particularly pain and bloating, compared with the mNICE diet.

First Authors:
Shanti L Eswaran

Correspondence Authors:
Kenya Jackson

All Authors:
Shanti L Eswaran,William D Chey,Theresa Han-Markey,Sarah Ball,Kenya Jackson

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