gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLCgastro-j-1171Research ArticleЛЕКЦИИ И ОБЗОРЫLECTURES AND REVIEWSРоль дефицита пищевых волокон в развитии проявлений и течении гастроэзофагеальной рефлюксной болезниThe role of nutritional fiber deficiency in the pathogenesis and course of gastroesophageal reflux diseaseМорозовС. В.MorozovS. V.

Морозов Сергей Владимирович – старший научный сотрудник

115446, Москва, Каширское шоссе, 21

Morozov Sergey V. – senior researcher

115446, Moscow, Kashirskoye Shosse, 2

morosoffsv@mail.ruКучерявыйЮ. А.KucheryavyyYu. A.КукушкинаМ. Д.KukushkinaM. D.ФГБУ «НИИ питания» РАМНРоссияResearch Institute of Nutrition of Russian Academy of Medical SciencesRussian FederationГБОУ ВПО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава РоссииРоссияMoscow State University of Medicine and Dentistry named after A.I. EvdokimovRussian Federation201316052024231612Copyright © Морозов С.В., Кучерявый Ю.А., Кукушкина М.Д., 20132013Морозов С.В., Кучерявый Ю.А., Кукушкина М.Д.Morozov S.V., Kucheryavyy Y.A., Kukushkina M.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/1171

Цель обзора. Проанализировать имеющиеся в настоящее время в системе Medline/PubMed исследования о влиянии пищевых волокон (ПВ) на развитие проявлений и течение заболевания у больных гастроэзофагеальной рефлюксной болезнью (ГЭРБ), данные о группе наблюдения, применявшихся методах и полученных результатах.Основные положения. Существуют множественные теоретические предпосылки положительного влияния ПВ на течение ГЭРБ. Обогащение пищи ПВ может способствовать уменьшению риска развития проявлений заболевания за счет ряда факторов: адсорбции химических веществ, способных повреждать слизистую оболочку пищевода и расслаблять нижний пищеводный сфинктер (NO, соляная кислота, ферменты, желчные кислоты), ускорения эвакуации желудочного содержимого, снижения внутрижелудочного давления, уменьшения постпрандиальной секреции соляной кислоты и т. д. Рассмотрены патогенетические механизмы, обусловливающие взаимосвязь дефицита пищевых волокон и факторов патогенеза ГЭРБ, а также прямые свидетельства взаимосвязи между потреблением ПВ и риском развития болезни по данным эпидемиологических исследований.Заключение. Имеющиеся сведения далеки от полноты и требуют дальнейшей оценки в специально спланированных проспективных исследованиях. Однако как косвенные предпосылки о влиянии ПВ на патогенетические факторы ГЭРБ, так и результаты эпидемиологических исследований свидетельствуют о том, что использование ПВ в модификации рациона больных ГЭРБ может оказывать положительное влияние, особенно в отдельных группах пациентов с ожирением и/или замедленным кишечным транзитом.

Aim of the Review

Aim of the Review. To analyze current data about possible influence of nutritional fiber on the course of GERD.

Key points

Key points. Systematic review in PubMed/Medline databases was performed with keywords food, dietary fiber in combination with gastroesophageal reflux, GERD. The review contains data concerning influence of nutritional fiber on the pathogenetic mechanisms of GERD and illuminates results of epidemiological studies suggesting positive correlation between quantities of nutritional fiber in the patient’s diet and manifestations of the disease. The main features of pathogenesis caused by the lack of nutritional fiber include slow gastric emptying, increased gastric volume, increased risk of obesity and hiatal hernia, reduced lower esophageal sphincter pressure. The epidemiological studies suggest the higher incidence of GERD symptoms, higher prevalence of Barrett’s esophagus and esophageal adenocarcinoma in patients who consume low quantity of nutritional fiber.

Conclusion

Conclusion. Despite the lack of interventional studies the literature data about impact of nutritional fiber on the manifestations of GERD show probable approach for the correction of diet in GERD patients. There is a need for prospective studies evaluating correction of diet on the course of the disease.

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The authors declare that there are no conflicts of interest present.