AIM: To investigate patient-reported outcomes from, and adherence to, a low FODMAP diet among patients suffering from irritable bowel syndrome and inflammatory bowel disease.METHODS: Consecutive patients with irritabl...AIM: To investigate patient-reported outcomes from, and adherence to, a low FODMAP diet among patients suffering from irritable bowel syndrome and inflammatory bowel disease.METHODS: Consecutive patients with irritable bowel syndrome(IBS) or inflammatory bowel disease(IBD) and co-existing IBS fulfilling the ROME Ⅲ criteria, who previously attended an outpatient clinic for low FODMAP diet(LFD) dietary management and assessment by a gastroenterologist, were invited to participate in a retrospective questionnaire analysis. The questionnaires were sent and returned by regular mail and gathered information on recall of dietarytreatment, efficacy, symptoms, adherence, satisfaction, change in disease course and stool type, and quality of life. Before study enrolment all patients had to sign an informed written consent.RESULTS: One hundred and eighty patients were included, 131(73%) IBS and 49(27%) IBD patients. Median age was 43 years(range: 18-85) and 147(82%) were females. Median follow-up time was 16 mo(range: 2-80). Eighty-six percent reported either partial(54%) or full(32%) efficacy with greatest improvement of bloating(82%) and abdominal pain(71%). The proportion of patients with full efficacy tended to be greater in the IBD group than in the IBS group(42% vs 29%, P = 0.08). There was a significant reduction in patients with a chronic continuous disease course in both the IBS group(25%, P < 0.001) and IBD group(23%, P = 0.002) along with a significant increase in patients with a mild indolent disease course of 37%(P < 0.001) and 23%(P = 0.002), respectively. The proportion of patients having normal stools increased with 41% in the IBS group(P < 0.001) and 66% in the IBD group(P < 0.001). One-third of patients adhered to the diet and high adherence was associated with longer duration of dietary course(P < 0.001). Satisfaction with dietary management was seen in 83(70%) IBS patients and 24(55%) IBD patients. Eightyfour percent of patients lived on a modified LFD, where some foods rich in FODMAPs were reintroduced, and 16% followed the LFD by the book without deviations. Wheat, dairy products, and onions were the foods most often not reintroduced by patients.CONCLUSION: These data suggest that a diet low in FODMAPs is an efficacious treatment solution in the management of functional bowel symptoms for IBS and IBD patients.展开更多
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。
基金Supported by the Danish patient society of inflammatory bowel disease and irritable bowel syndrome patients,Colitis Crohn Foreningen
文摘AIM: To investigate patient-reported outcomes from, and adherence to, a low FODMAP diet among patients suffering from irritable bowel syndrome and inflammatory bowel disease.METHODS: Consecutive patients with irritable bowel syndrome(IBS) or inflammatory bowel disease(IBD) and co-existing IBS fulfilling the ROME Ⅲ criteria, who previously attended an outpatient clinic for low FODMAP diet(LFD) dietary management and assessment by a gastroenterologist, were invited to participate in a retrospective questionnaire analysis. The questionnaires were sent and returned by regular mail and gathered information on recall of dietarytreatment, efficacy, symptoms, adherence, satisfaction, change in disease course and stool type, and quality of life. Before study enrolment all patients had to sign an informed written consent.RESULTS: One hundred and eighty patients were included, 131(73%) IBS and 49(27%) IBD patients. Median age was 43 years(range: 18-85) and 147(82%) were females. Median follow-up time was 16 mo(range: 2-80). Eighty-six percent reported either partial(54%) or full(32%) efficacy with greatest improvement of bloating(82%) and abdominal pain(71%). The proportion of patients with full efficacy tended to be greater in the IBD group than in the IBS group(42% vs 29%, P = 0.08). There was a significant reduction in patients with a chronic continuous disease course in both the IBS group(25%, P < 0.001) and IBD group(23%, P = 0.002) along with a significant increase in patients with a mild indolent disease course of 37%(P < 0.001) and 23%(P = 0.002), respectively. The proportion of patients having normal stools increased with 41% in the IBS group(P < 0.001) and 66% in the IBD group(P < 0.001). One-third of patients adhered to the diet and high adherence was associated with longer duration of dietary course(P < 0.001). Satisfaction with dietary management was seen in 83(70%) IBS patients and 24(55%) IBD patients. Eightyfour percent of patients lived on a modified LFD, where some foods rich in FODMAPs were reintroduced, and 16% followed the LFD by the book without deviations. Wheat, dairy products, and onions were the foods most often not reintroduced by patients.CONCLUSION: These data suggest that a diet low in FODMAPs is an efficacious treatment solution in the management of functional bowel symptoms for IBS and IBD patients.
