Role of nutritional factors at the irritable bowel syndrome
Abstract
The aim of review. To discuss effect of certain types of food at irritable bowel syndrome (IBS) and options of reduction of symptom intensity by individual adjustment of ration.
Key points. Undoubtedly, dietary habits in the most cases influence severity of IBS symptoms: pain, flatulence, stool disorders. Most likely, negative action of food substances is realized partly due to fermentation with excessive production of short-chain fatty acids and intestinal gas, partly — because of effect on the microbiota spectrum and enteroendocrine cells, partly - due to elevation of biogenic amine content. Filling of food diary helps to find out relevant food substances. Effect of fermentable oligo-, di- and monosaccharides and sugar spirits (FODMAPs) is most obviously demonstrated, therefore it is necessary to choose products with decreased contents of these components. In some cases negative action is related to products with high gluten content, though whether it is caused by effect of gluten or action of fructans, remains equivocal. Efficacy of functional food products containing bacteria of probiotic strain Bifidobacterium animalis sp. lactis DN-173 010 for treatment of IBS symptoms is demonstrated in clinical trials. At detection of symptoms link to intake of specific products it is necessary to exclude food allergy and enzymopathies (e.g. lactase deficiency), which should be defined as independent diseases under the «mask» of irritable bowel syndrome.
Conclusion. Individually adjusted nutrition is an integral part of treatment of IBS. Progress achieved in studying of food factors contribution to symptom development, forms scientific basis for recommendation to eliminate certain nutrients from the ration and simultaneously promotes better understanding of disease pathogenesis.
About the Authors
Yu. O. Shulpekova
State educational government financed institution of higher professional education «Sechenov First Moscow state medical university»
Russian Federation
Russian Federation
Shulpekova Yulia O. – lecturer, Chair of internal diseases propedeutics, medical faculty
119991, Moscow, Pogodinskaya street, 1, bld 1
A. V. Sedova
State educational government financed institution of higher professional education «Sechenov First Moscow state medical university»
Russian Federation
Russian Federation
Sedova Alla V. – assistant-professor, Chair of internal diseases propedeutics, medical faculty
References
1. El-Salhy M., Gundersen D. Diet in irritable bowel syndrome. Nutr J 2015; 14:36.
2. El-Salhy M. Irritable bowel syndrome: diagnosis and pathogenesis. World J Gastroenterol 2012; 18:5151-63.
3. Boettcher E., Crowe S.E. Dietary proteins and functional gastrointestinal disorders. Am J Gastroenterol 2013; 108:728-36.
4. Manabe N., et al. Pathophysiology underlying irritable bowel syndrome - from the viewpoint of dysfunction of autonomic nervous system activity. J Smooth Muscle Res 2009; 45(1):15-23.
5. Patman G. IBS: Mast cells cause nerves to sprout in patients with IBS. Nat Rev Gastroenterol Hepatol 2015; 12(4):189.
6. Joneja J.M. Histamine intolerance, diamine oxidase activity, and probiotics. Интернет-страница http://www. allergynutrition.com/wp-content/uploads/2014/05/ Histamine-DAO-and-Probiotics-Revised.pdf. 20 мая 2015 г.
7. Marsh A., et al. Does a diet low in FODMAPs reduce symptoms associated with functional gastrointestinal disorders? A comprehensive systematic review and metaanalysis. Eur J Nutr 2015 May 17 [Epub ahead of print].
8. Halmos E.P., et al. Diets that differ in their FODMAP content alter the colonic luminal microenvironment. Gut 2015; 64:93-100.
9. Mazzawi T., et al. Normalization of large intestinal endocrine cells following dietary management in patients with irritable bowel syndrome. Eur J Clin Nutr. in press 2015.
10. Francis C.Y., Whorwell P.J. Bran and irritable bowel syndrome: time for reappraisal. Lancet 1994; 344:39-40.
11. Bijkerk C.J., et al. Systematic review: the role of different types of fibre in the treatment of irritable bowel syndrome. Aliment Pharmacol Ther 2004; 19:245-51.
12. Sapone A., et al. Divergence of gut permeability and mucosal immune gene expression in two gluten-associated conditions: celiac disease and gluten sensitivity. BMC Med 2011; 9:23.
13. Campanella J., et al. Clinical response to gluten withdrawal is not an indicator of coeliac disease. Scand J Gastroenterol 2008; 43:1311-4.
14. Vazquez-Roque M.I., et al. A controlled trial of glutenfree diet in patients with irritable bowel syndrome-diarrhea: effects on bowel frequency and intestinal function. Gastroenterology 2013; 144:903-11.
15. Carroccio A., et al. Non-celiac wheat sensitivity diagnosed by double-blind placebo-controlled challenge: exploring a new clinical entity. Am J Gastroenterol 2012; 107:1898-906.
16. Nijeboer P., et al. Non-celiac gluten sensitivity. Is it in the gluten or the grain? J Gastrointestin Liver Dis 2013; 22:435-40.
17. Biesiekierski J.R., et al. No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, shortchain carbohydrates. Gastroenterology 2013; 145:320-8.
18. Gibson P.R., et al. Other Dietary Confounders: FODMAPS et al. Dig Dis 2015; 33(2):269-76.
19. Biesiekierski J.R., Iven J. Non-coeliac gluten sensitivity: piecing the puzzle together. United Eur Gastroenterol J 2015; 3(2):160-5.
20. Poluektova Ye.A., Kuchumova S.Yu., Sheptulin A.A., Ivashkin V.T. Treatment of irritable bowel syndrome from standpoints of modern concept of pathogenesis. Ros zhurn gastroenterol gepatol koloproktol 2013; 23 (1):57-65.
21. Poluektova Ye.A., Kuchumova S.Yu., Shifrin O.S., Sheptulin A.A., Ivashkin V.T. Pathogenic role of intestinal microflora changes at irritable bowel syndrome and potential of their treatment. Ros zhurn gastroenterol gepatol koloproktol 2014; 24(6):89-97.
22. Diaz Heijtz R., Wang S., Anuar F. Normal gut microbiota modulates brain development and behavior. Proc Natl Acad Sci USA 2011;108(7):3047-52. 23. El-Salhy M., et al. Effects of a health program comprising reassurance, diet management, probiotic administration and regular exercise on symptoms and quality of life in patients with irritable bowel syndrome. Gastroenterology Insights. 2010; 2:21-6.
23. Marteau P., et al. Bifidobacterium animalis strain DN-173 010 shortens the colonic transit time in healthy women: a double-blind, randomized, controlled study. Aliment Pharmacol Ther 2002; 16:587-93.
24. Agrawal A., et al. Clinical trial: the effects of a fermented milk product containing Bifidobacterium lactis DN-173 010 on abdominal distension and gastrointestinal transit in irritable bowel syndrome with constipation. Aliment Pharmacol Ther 2009; 29(1):104-14.
25. Guyonnet D., et al. Effect of a fermented milk containing Bifidobacterium animalis DN-173 010 on the health-related quality of life and symptoms in irritable bowel syndrome in adults in primary care: a multicentre, randomized, double-blind, controlled trial. Aliment Pharmacol Ther 2007; 26(3):475-86.
Review
For citations:
Shulpekova Yu.O., Sedova A.V. Role of nutritional factors at the irritable bowel syndrome. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2015;25(5):94-100. (In Russ.)
Views:
102
Email this article 
