FODMAP在肠易激综合征患者中的作用
肠易激综合征（IBS）主要表现为腹痛、腹胀、胃肠胀气和大便习惯改变。膳食组成成分对IBS症状的影响难以确定。至今，食物不被认为是一种病因，而是促使症状出现的因素。所谓FODMAP（可发酵寡聚糖、二糖、单糖、多元糖）饮食受到特别关注。我们的目的是总结来自管理IBS可疑不耐受食物最常见方案中的证据，特别关注FODMAP及低FODMAP饮食的效果。我们对文献进行综述，在Pubmed和Medine中用检索词FODMAP、果糖、乳糖、果聚糖、半乳聚糖、多元醇（山梨醇、甘露醇、麦芽糖醇、木糖醇、赤藓糖醇、聚葡萄糖和异麦芽酮糖醇）、肠易激综合征和功能性胃肠道症状进行检索。限制FODMAP饮食较长时间用于IBS患者。所谓FODMAP概念的创新在于一个广泛限制的饮食应该比一个有限限制的饮食在预防腹胀方面效果更持久。即使所有可能的低FODMAP饮食能很好地缓解许多患者的症状，但对于其他患者仅能稍有缓解。一些研究强调低FODMAP饮食改善IBS患者症状的作用。关于这一饮食方案的研究证据支持低FODMAP饮食应是首选饮食方案的假说。然而，许多方面仍有待弄清楚，包括评估可能出现的明显的营养问题。
Nutr Clin Pract. 2015;30(5):665-82.
Role of FODMAPs in Patients With Irritable Bowel Syndrome.
Mansueto P, Seidita A, D'Alcamo A, Carroccio A.
University Hospital of Palermo, Palermo, Italy.
Sciacca Hospital, Agrigento, Italy.
University of Palermo, Palermo, Italy.
Irritable bowel syndrome (IBS) is a condition characterized by abdominal pain, bloating, flatus, and altered bowel habits. The role of dietary components in inducing IBS symptoms is difficult to explore. To date, foods are not considered a cause but rather symptom-triggering factors. Particular interest has been given to the so-called FODMAPs (fermentable oligo-, di-, and monosaccharides and polyols). We aimed to summarize the evidence from the most common approaches to manage suspected food intolerance in IBS, with a particular interest in the role of FODMAPs and the effects of a low FODMAP diet. We reviewed literature, consulting PubMed and Medline by using the search terms FODMAP(s), fructose, lactose, fructans, galactans, polyols (sorbitol, mannitol, maltitol, xylitol, erythritol, polydextrose, and isomalt), irritable bowel syndrome, and functional gastrointestinal symptoms. FODMAP-restricted diets have been used for a long time to manage patients with IBS. The innovation in the so-called FODMAP concept is that a global restriction should have a more consistent effect than a limited one in preventing abdominal distension. Even though all the potential low FODMAP diets provide good relief of symptoms in many patients, there is just a little relief in others. Several studies highlight the role of low FODMAP diets to improve symptoms in patients with IBS. The evidence on this dietary approach supports the hypothesis that a low FODMAP diet should be the first dietary approach. However, many points remain to be clarified, including the evaluation of possibly significant nutrition concerns.
KEYWORDS: FODMAP; diet therapy; disaccharides, monosaccharides; gastrointestinal diseases; irritable bowel syndrome; oligosaccharides
PMID: 25694210
DOI: 10.1177/0884533615569886