References

gastro-j

Российский журнал гастроэнтерологии, гепатологии, колопроктологии

Russian Journal of Gastroenterology, Hepatology, Coloproctology

1382-43762658-6673

«Gastro» LLC

10.22416/1382-4376-2017-27-4-22-27

gastro-j-165

Research Article

ЛЕКЦИИ И ОБЗОРЫ

LECTURES AND REVIEWS

Диета с пониженным содержанием ферментируемых олиго-, ди-, моносахаридов и полиолов (fodmap) в лечении синдрома раздраженного кишечника

Diet with decreased content of fermentable oligo-, diand monosaccharides and polyols (low FODMAP-diet) in treatment of irritable bowel syndrome

Халиф

И. Л.

Khalif

I. L.

noemail@neicon.ru

Тишаева

И. А.

Tishaeva

I. A.

noemail@neicon.ru

ФГБУ «Государственный научный центр колопроктологии им. А.Н. Рыжих»РоссияFederal government-financed institution «Ryzhikh State Scientific Center of Coloproctology»Russian Federation

2017

12082018

2742227

2018

Халиф И.Л., Тишаева И.А.

Khalif I.L., Tishaeva I.A.

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/165

Цель обзора. Представить данные литературы о диете с пониженным содержанием ферментируемых олиго, ди, моносахаридов и полиолов в лечении больных с синдромом раздраженного кишечника (СРК). Основные положения. Освещена роль ферментируемых углеводов в развитии симптомов СРК. Рассмотрены основные принципы диеты FODMAP, ее преимущества и недостатки. Заключение. Короткоцепочечные углеводы вызывают повышенное газообразование в толстой кишке, влияют на ее моторику, оказывают осмотический эффект, что способствует развитию симптомов СРК. Диета с пониженным содержанием ферментируемых олиго, ди, моносахаридов и полиолов уменьшает выраженность симптоматики у пациентов и может быть использована в лечении больных с СРК.

Aim of review. To present the literature data on efficacy of the diet with decreased content of fermentable oligo, di and monosaccharides and polyols (low FODMAP diet) for irritable bowel syndrome (IBS) treatment. Summary. The role of fermentable carbohydrates in development of IBS symptoms is discussed, the basic principles of low FODMAPdiet, its advantage and shortcomings are reviewed. Conclusion. Shortchain carbohydrates cause increased colonic gas production, influence large intestinal motility, exert osmotic effect that promotes development of IBS symptoms. Low FODMAPdiet reduces symptom severity and can be applied for IBS treatment.

синдром раздраженного кишечникадиета с пониженным содержанием ферментируемых олиго-ди-моносахаридов и полиоловсиндром раздраженного кишеч-никадиета с пониженным содержанием ферменти-руемых олиго-димоносахаридов и полиолов

References1

Lovell R.M..&.Ford A.C. Clin Gastroenterol Hepatol 2012;10: 712-21.

Doshi J.A., Cai Q., Buono J.L. et al. Economic burden of irritable bowel syndrome with constipation: a retrospective analysis of health care costs in a commercially insured population. J Manag Care Spec Pharm 2014;20(4):382-90.

Drossman D.A., Hasler W.L. Rome IV-Functional GI Disorders: Disorders of Gut-Brain Interaction. Gastroenterology 2016; 150:1257-61.

Ивашкин В.Т., Шелыгин Ю.А., Баранская Е.К. и др. Клинические рекомендации Российской гастроэнтерологической ассоциации и Ассоциации колопроктологов России по диагностике и лечению больных с синдромом раздраженного кишечника. Рос журн гастроэнтерол гепатол колопроктол 2014; 24(2):92-101.

Chey W.D., Kurlander J., Eswaran S. Irritable bowel syndrome: a clinical rewiew. JAMA 2015; 313(9): 949-958.

Simren M., Barbara G., Flint H.J. et al. Intestinal microbiota in fucnctional bowel disorders: a Rome foundation report. Gut 2013;62(1):159-76.

DuPont A.W., DuPont H.L. The intestinal microbiota and chronic disorders of the gut. Nat Rew Gactroenterol Hepatol. 2011;8(9):523-31.

DuPont H.L. Rewiew article: evidence for the role of gut microbiota in irritable bowel syndrome and its potencial influence on therapeutic targets. Aliment Pharmacol Ther 2014;39(10):1033-42.

Шептулин А.А., Визе-Хрипунова М.А. Римские критерии синдрома раздраженного кишечника IV пересмотра: есть ли принципиальные изменения? Рос журн гастроэнтерол гепатол колопроктол 2016;26(5):99-103.

Шульпекова Ю.О., Седова А.В. Значение факторов питания при синдроме раздраженного кишечника. Рос журн гастроэнтерол гепатол колопроктол 2016; 25(5):94-100.

Hayes P.A. Fraher M.N., Quigley E.M.M. Irritable bowel syndrome: the role of food in pathogenesis and management. Gastroenterol Hepatol (N Y). 2014;10(3): 164-74.

Simren M., Mansson A., Langkilde A.M. et al. Food related gastrointestinal symptoms in the irritable bowel syndrome. Digestion. 2001; 63(2):108-15.

Heizer W.D., Southern S., McGovern S. The role of diet in symptoms of irritable bowel syndrome in adults: a narrative rewiew. J Am Diet Assos 2009;109:1204-14.

Bohn L., Storsrus S., Tornblom H., Bengtsson U., Simren M. Self-reported food-related gastrointestinal symptoms in IBS arecommon and associated with more severe symptoms and reduced quality of life. Am J Gastroenterol. 2013;108(5):634-41.

Halpert A., Dalton C.B., Palsson O. et al. What patients know about irritable bowel syndrome (IBS) and what they would like to know. National Survey on Patients Educational Needs in IBS and development and validation of the Patient Educational Needs Questionarie (PEQ). Am J Gastroenterol 2007;102(9):1972-82.

Monsbakken K.W., Vandvik P.O., Farup P.G. Perceived food intolerance in subjects with irritable bowel syndrome -etiology, prevalence and consequences. Eur J Clin Nutr 2006;60:667-72.

Cummings J.H. & Stephen A.M. Carbohyrate terminology and classification. Eur.J.Clin.Nutr.(Suppl.1)2007; 61: S5-S18

Маевская М.В., Маевский Р.М. Еда как образ жизни. Рос журн гастроэтерол гепатол колопроктол 2016; 26(5):104-15.

Berghouse L. et al. Comparison between the bacterial and oligosaccharide content of ileostomy effluent in subjects taking diets rich in refined or inrefined carbohydrate. Gut 1984;25:1071-7.

Lanhkilde A.M., Anderson H., Schweizer T.F. & Wursch P. Digestion and absorption of sorbitol, maltitol and isomalt from the small bowel. A study in ileostomy subjects. Eur J Clin Nutr 1994;48:768-75.

Barrett, J.S. et al. Dietary poorly absorbed, short-chain carbohydrates increase delivery of water and fermentable substrates to the proximal colon. Aliment Pharmacol Ther 2010;31:874-882

Marciani L. et al. Postprandial changes in small bowel water content in healthy subjects and patients with irritable bowel syndrome. Gastroenterology 2010;138:46977.

Thomas A. Quigley EMM. Diet and irritable bowel syndrome. Curr Opin Gastroenterol 2015;31(2):166-71.

Heidi M., Staudacher Peter., M. Irving., Miranda C.E. Lomer and Kevin Whelan. Mechanisms and efficacy of dietary FODMAP restriction in IBS. Nat Rev Gastroenterol Hepatol 2014; 11(4):256-66.

King T.S., Elia M., Hunter J.O. Abnormal colonic fermentation in irritable bowel syndrome. Lancet 1998;352:1187-9.

Ong D.K. et al. Manipulation of dietaryy short chain carbohydrates alters the pattern of gas production and genesis of symptoms in irritable bowel syndrome. J Gastroenterol. Hepatol 2010;25:1366-73.

Murray K. et al., Different effects of FODMAPs (fermentable oligo-, di-, mono-saccharides and polyols) on small and large intestinal contents in healthy subjects shown by MRI. Am J Gastroenterol 2014;109:110-9.

Chey W.D., Kurlander J., Eswaran S. Irritable bowel syndrome: a clinical rewiew. JAMA 2015; 313(9): 949-58.

Zhu Y. et al. Bloating and distention in irritable bowel syndrome: The role of gas production and visceral sensation after lactose ingestion in a population with lactase deficiency. Am J Gastroenterol 2013;108:1516-25.

Madsen J.L., Linnet, J. & Rumessen J.J. Effecr of nonabsorbed amounts of a fructose-sorbitol mixture on small intestinal transit in healthy volunteers. Dig Dis Sci 2006;51:147-53.

Low FODMAP diet for Irritable Bowel Syndrome, http://www.med.monash.edu/cecs/gastro/fodmap/

Roberfroid M. B Inulin-type fructans: functional food ingredients. J Nutr 2007;137(Suppl.11):2493S-2502S.

Roberfroid M. et al. Prebiotic effects: metabolic and health benefits Br.J. Nutr. 2010;104 (Suppl.2): S1-S63.

Macfarlane G.T., Steed H. & Macfarlane S. Bacterial metabolism and health-related effects of galactooligosaccharides and other prebiotics. J Appl Microbiol 2008;104:305-44.

Lumer M.C., Parkes G.C. & Sanderson J.D. Rewiew article: lactose intolerance in clinical practice: myths and realities. Aliment Pharmacol Ther 2008;27:93-103.

Yang J. et al. Prevalence and presentation of lactose intolerance and effects on dairy product intake in healthy subjects and patients with irritable bowel syndrome. Clin Gastroenterol Hepatol 2013;11:262-68.

Barrett J.S., Irving P.M., Shepherd S.J., Muir J.G. & Gibson P.R. Comparison of the prevalence of fructose and lactose malabsorption across chronic intestinal disorders. Alment Pharmacol Ther 2009;30:165-74.

Jones H.F., Butler R.N. & Brooks D.A. Intestinal fructose transport amd malabsorption in humans.Am J Physiol Gastrointest Liver Physiol 2011;300: G202-6.

Hernot D.C. et al. In vitro fermentation profiles, gas production rates, and microbiota modulation as effected by certain fructans, galactooligosaccharides and polydextrose. J Agric Food Chem 2009;57:1354-61.

Pedersen N., Andersen N.N., Vegh Z. et al. Ehaealth: Low FODMAP diet vs Lactobacillus rhamnosus GG in irritable bowel syndrome. World J Gastroenterol 2014;20:16215-26.

Barrett J.S., Gibson P.R. Fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) and nonallergic food intolerance: FODMAPs or food chemicals? Therap Adv Gastroenterol 2012;5:261

Shepherd S.J., Parker F.C., Muir J.G., Gibson P.R. Dietary triggers of abdominal symptoms in patient with irritable bowel syndrome: randomized placebocontrolled evidence. Clin Gastroenterol Hepatol. 2008;6(7):765-71.

Tuck C.J., Muir J.G., Barrette J.S., Gibson P.R. Fermentable oligosaccharides, disaccharides, monosaccarides and polyols: role in irritable bowel syndrome. Expert Rev Gastroenterol Hepatol 2014;8(7):819-34.

Halmos E.P., Power V.A., Shepherd S.J., Gibson P.R., Muir J.G. A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology 2014;146(1):67-75.e.5.

Shepherd S.J., Gibson P.R. Fructose malabsorption and symptoms of irritable bowel syndrome: guidelines for the dietary management. J Am Diet Assoc 2006;106:1631-9.

de Roest R.H., Dobbs B.R., Chapman B.A. et al. The low FODMAP diet improves gastrointestinal symptoms in patient with irritable bowel syndrome: a prospective study. Int J Clin Pract 2013;67:895-903.

Staudacher H.M., Whelan K., Irving P.M., Lomer M.C. Comparison of symptom response following advice for a diet low in fermentable carbohydrates (FODMAPs) versus standart dietary advice in patient with irritable bowel syndrome. J Hum Nutr Diet 2011;24(5):487-95.

Rao S.S.C., Yu S., Fedewa A. Systematic rewiew: dietary fibre and FODMAP-restricted diet in the management of constipation and irritable bowel syndrome. Aliment Pharmacol Ther 2015;41(12):1256-70.

Misha S. Randomised double blind placebo control studies, the «Gold Standart» in intervention based studies. Indian J Sex Trans Dis 2012;33(2):131-4.

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