Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Constipation/diet therapy , Irritable Bowel Syndrome/diet therapy , Psyllium , Treatment Outcome , FruitABSTRACT
A partir del caso de una paciente con síndrome de intestino irritable a predominio de estreñimiento cuyos síntomas mejoraron con el consumo regular de kiwi, el médico de familia se planteó la pregunta de si el kiwi podría mejorar los síntomas asociados a constipación crónica en comparación con el tratamiento habitual. Tras realizar una búsqueda de estudios que analizaran los efectos del consumo de kiwi sobre el hábito intestinal, fueron seleccionados tres artículos que permiten concluir que el consumo de esta fruta tiene una eficacia superior al placebo y comparable al psyllium y las pasas de ciruela para mejorar los síntomas de personas con estreñimiento crónico. (AU)
Based on the case of a patient with constipation-predominant irritable bowel syndrome whose symptoms improved with regular consumption of kiwi, the family doctor wondered if kiwi could improve symptoms associated with chronic constipation compared to usual treatment. After conducting a search for studies that analyzed the effects of kiwi consumption on intestinal habit, three articles were selected that allow us to conclude that the consumption of this fruit has an efficacy superior to placebo and comparable to psyllium and plum raisins to improve the symptoms of people with chronic constipation. (AU)
Subject(s)
Humans , Female , Middle Aged , Constipation/diet therapy , Irritable Bowel Syndrome/diet therapy , Fruit , Psyllium/therapeutic use , Abdominal Pain/diet therapy , Randomized Controlled Trials as Topic , Constipation/diagnosis , Actinidia , Irritable Bowel Syndrome/diagnosis , Feces , Systematic Reviews as TopicSubject(s)
Humans , Male , Female , Pregnancy , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Irritable Bowel Syndrome/therapy , Fecal Microbiota Transplantation/trends , Polyethylene Glycols/therapeutic use , Quality of Life , Signs and Symptoms, Digestive , Abdominal Pain/diagnosis , Randomized Controlled Trials as Topic , Irritable Bowel Syndrome/surgery , Irritable Bowel Syndrome/diet therapy , Dyspepsia/diagnosis , Fatigue/diagnosis , Feces , Dysbiosis/diagnosis , Fecal Microbiota Transplantation/adverse effects , Gastrointestinal Microbiome/physiology , Saline Solution/therapeutic use , Loperamide/therapeutic useABSTRACT
Resumen Introducción. Cada vez hay más información sobre la efectividad de una dieta baja en oligosacáridos, disacáridos, monosacáridos y polioles fermentables (Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols, FODMAP) en pacientes con síndrome de intestino irritable. Sin embargo, no hay estudios que estimen la eficacia de esta estrategia en nuestro medio. Objetivo. Determinar el efecto de una dieta baja en FODMAP en la calidad de vida y en la intensidad de los síntomas en pacientes con síndrome de intestino irritable en Colombia. Materiales y métodos. Se recopiló información clínica y demográfica de todos los pacientes en el momento de su inclusión; después, un encuestador entrenado utilizó la encuesta Irritable Bowel Syndrome Quality of Life (IBS-QoL) para estimar la calidad de vida de los pacientes. La intensidad de los síntomas se evaluó mediante una escala visual, antes y después del inicio de la dieta baja en FODMAP. Resultados. La muestra final incluyó a 50 personas. Se observó una reducción significativa de todos los síntomas (reducción promedio de todas las escalas: 19,8 mm; IC95%: 16,2-23,4 mm; p<0,001), y un incremento en todas las escalas de la IBS-QoL, incluida la de resumen global de la encuesta (14,7 puntos; IC95%: 9,4-20,1; p<0,001). El sexo, la edad, el índice de masa corporal, el estado socioeconómico y el régimen de salud, no se asociaron con la mejoría de la calidad de vida relacionada con la salud. Conclusión. La dieta supervisada y baja en FODMAP disminuyó los síntomas y mejoró la calidad de vida en pacientes con síndrome de intestino irritable. Es necesario hacer estudios controlados sobre otros factores ligados a la evolución del síndrome para confirmar estos resultados.
Abstract Introduction: A growing body of evidence has pointed out the effectiveness of a diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) in patients with irritable bowel syndrome. However, there are no local studies to estimate the effects of this strategy on the symptoms and the health-related quality of life in these patients in Colombia or Latin America. Objective: To determine the effect of a diet low in FODMAP on the quality of life and the severity of symptoms in patients with irritable bowel syndrome in Colombia. Materials and methods: We collected clinical and demographic information of all patients at the time of inclusion. Immediately afterwards, a trained interviewer applied the IBS-QoL survey to estimate the quality of life of patients. Then, we evaluated the intensity of the symptoms using an analogue visual scale, before and after the diet low in FODMAP. Results: We included 50 subjects in the final analysis. We observed an increase in all the IBS-QoL scales (average increase in overall summary: 14.7 points, 95% CI: 9.4 to 20.1; p<0.001) and a significant reduction in all symptoms (-19.8 mm; 95% CI: 23.4 mm 16.2 mm; p<0.001). Sex, age, body mass index, socioeconomic status and the health care provider were not associated with the improvement in the health-related quality of life. Conclusion: A low diet in FODMAP reduced symptoms and improved quality of life in Colombian patients with irritable bowel syndrome. Controlled studies taking into account other factors linked to the severity of irritable bowel syndrome are required.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Oligosaccharides , Polymers , Quality of Life , Irritable Bowel Syndrome/diet therapy , Disaccharides , Diet, Carbohydrate-Restricted , Monosaccharides , Prospective Studies , Treatment Outcome , ColombiaABSTRACT
La dieta baja en FODMAP ha mostrado ser una herramienta eficaz en el manejo de los síntomas del Síndrome de Intestino Irritable (SII). Los estudios recientes aleatorizados, controlados y prospectivos apoyan el uso de esta dieta como parte del tratamiento de esta patología. Los mecanismos mediante los que la dieta baja en FODMAP alivia los síntomas son variados y se relacionan con la fisiopatología del SII. Esta dieta puede generar cambios en la flora intestinal, efecto que aún no ha sido ampliamente estudiado.
The low FODMAP diet has been shown to be an efficacious therapy for reduction of functional gastrointestinal symptoms seen in Irritable Bowel Disease (IBS). Recent publications provide randomized controlled trial and prospective evidence in support of the diet for symptom management. The mecanisms of the low FODMAP diet to relief sympotms are assorted and in realtionship with the physiopathology of IBS. This diet can turno n changes in microbiota. This effect has not be completely understood. Further research to determine the potential health implications and microbiotal effect is required.
Subject(s)
Humans , Irritable Bowel Syndrome/diet therapy , Diet, Carbohydrate-Restricted , Polysaccharides/adverse effects , Diet Therapy , Monosaccharides/adverse effectsABSTRACT
A Síndrome do Intestino Irritável (SII) é considerada, a partir do Consenso de ROMA III, um distúrbio gastrointestinal funcional, caracterizado por dor, mudança no hábito intestinal, distensão abdominal e constipação e/ou diarreia. Este distúrbio é classificado de acordo com o padrão de perturbações do trânsito intestinal e seu tratamento depende da apresentação clínica. A terapia farmacológica é bastante diversificada; contudo, a primeira opção para o manejo da SII são as medidas não farmacológicas. Uma modificação dietética que está se mostrando eficaz na terapêutica da SII é a redução da ingesta de FODMEPs, que é acrônimo de fermentável, oligossacarídeos, dissacarídeos, monossacarídeos e polióis. Este trabalho objetiva analisar se esta dieta propicia benefícios no tratamento da SII. Para tanto, realizou-se uma revisão sistemática da literatura científica nas bases de dados eletrônicas Pubmed, Medline, Trip, Science Direct, Scielo. Não foram encontrados artigos em língua portuguesa. A avaliação metodológica foi CASP. Um total de onze artigos primários foi incluído na revisão. A maioria dos estudos não apenas correlaciona os FODMEPs aos sintomas da SII, mas também considera a dieta com restrição FODMEPs como um tratamento não farmacológico imprescindível. Sabe-se que a sintomatologia da SII é influenciada pela ação do sistema nervoso entérico por fatores psicológicos e alimentares. Estudos observacionais expõem a restrição de FODMEPs como uma abordagem inovadora para o alívio dos sintomas. Um obstáculo na redução de FODMEPs é a dificuldade de o paciente aderir à dieta, pois esta é muito restritiva. No cenário brasileiro, essa abordagem para a SII ainda não foi explorada, o que é notabilizado pela inexistência de estudos acerca do tema. Conclui-se que a redução da ingesta de FODMEPs é uma alternativa na abordagem terapêutica da SII refratária. Os gastroenterologistas não podem mais ignorar os efeitos benéficos desse tipo de dieta. Estudos que adaptam a dieta FODMEPs aos hábitos alimentares dos brasileiros precisam ser realizados com urgência.
Irritable Bowel Syndrome (IBS) is considered by ROME III Criteria a functional gastrointestinal disorder characterized by pain, change in bowel habits, abdominal distension and constipation and/or diarrhea. This disorder is classified according to the standard of intestinal symptoms and its treatment relies on clinical presentation. The pharmacologic therapy is diverse, however, the first option for the management of IBS are non-pharmacological measures. A dietary modification that has been effective in the treatment of IBS is reducing the intake of FODMAPs, which is an acronym of fermentable, oligosaccharides, disaccharides, monosaccharides and polyols. This work is a systematic review of scientific literature published on electronic databases such as Pubmed, Medline, Trip, Science Direct, Scielo and analyses whether this diet provides benefits to the treatment of IBS. There are not any articles in Portuguese on the subject and the methodological evaluation was conducted through CASP. Only ten primary studies were found and they were all included in this work. Most of these studies not only correlate FODMAPs with the symptoms of IBS, but also consider this restricted diet as an important non-pharmacological treatment. It is known that the symptoms of IBS are influenced by the action of the enteric nervous system, psychological and dietary factors. Observational studies show that restricting FODMAPs is an innovative approach for the relief of symptoms. One obstacle in reducing FODMAPs is its restrictive nature that discourages patients to adhere to it. In the Brazilian context, this approach to IBS has not been explored yet, which might be explained by the lack of studies on the subject. It was concluded that reducing the intake of FODMEPs is an alternative therapeutic approach to refractory IBS and gastroenterologists can no longer ignore the beneficial effects of this type of diet. Studies considering FODMAPs eating habits in Brazil still need to be undertaken.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Irritable Bowel Syndrome/diet therapy , Irritable Bowel SyndromeABSTRACT
No abstract available.
Subject(s)
Female , Humans , Male , Irritable Bowel Syndrome/diet therapyABSTRACT
No abstract available.