Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder worldwide and characterized mainly by abdominal pain and abnormal bowel movements. The pathological and physiological mechanisms of IBS are complex, making clinical treatment challenging. Dietary intervention is a common approach to treating IBS and significantly improving patients' quality of life. This article reviews the therapeutic effects and mechanisms of spome nutrients, such as carbohydrates, polyunsaturated fatty acids, dietary fiber, and vitamin D, in IBS, so as to provide a more reasonable dietary treatment plan for IBS patients.
SONG Yi-nan, YU Hai-ning, SHEN Sheng-rong.
THERAPEUTIC EFFECTS AND MECHANISMS OF SOME NUTRIENTS IN IRRITABLE BOWEL SYNDROME[J]. Acta Nutrimenta Sinica. 2024, 46(1): 95-101
中图分类号：
R574.4
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参考文献
[1] Black C J, Ford A C.Global burden of irritable bowel syndrome: trends, predictions and risk factors[J]. Nat Rev Gastroenterol Hepatol, 2020, 17:473–486. [2] Oka P, Parr H, Barberio B, et al. Global prevalence of irritable bowel syndrome according to Rome III or IV criteria: a systematic review and meta-analysis[J]. Lancet Gastroenterol Hepatol, 2020, 5:908–917. [3] Han L, Zhao L, Zhou Y, et al. Altered metabolome and microbiome features provide clues in understanding irritable bowel syndrome and depression comorbidity[J]. ISME J, 2022, 16:983–996. [4] Kurokawa S, Kishimoto T, Mizuno S, et al. The effect of fecal microbiota transplantation on psychiatric symptoms among patients with irritable bowel syndrome, functional diarrhea and functional constipation: an open-label observational study[J]. J Affect Disord, 2018, 235:506–512. [5] Mearin F, Lacy B E, Chang L, ,et al. Bowel disorders[J]. Gastroenterology. Bowel disorders[J]. Gastroenterology, 2016, 150:1393–1407.e5. [6] Aguilera-Lizarraga J, Hussein H, Boeckxstaens G E.Immune activation in irritable bowel syndrome: what is the evidence?[J]. Nat Rev Immunol, 2022, 22:674–686. [7] Paine P.Review article: current and future treatment approaches for pain in IBS[J]. Aliment Pharmacol Ther, 2021, 54(Suppl 1):S75–S88. [8] Lacy B E, Pimentel M, Brenner D M, et al. ACG clinical guideline: management of irritable bowel syndrome[J]. Am J Gastroenterol, 2021, 116:17–44. [9] Kamal A, Pimentel M.Influence of dietary restriction on irritable bowel syndrome[J]. Am J Gastroenterol, 2019, 114:212–220. [10] Mckenzie Y A, Bowyer R K, Leach H, et al. British dietetic association systematic review and evidence-based practice guidelines for the dietary management of irritable bowel syndrome in adults (2016 update)[J]. J Hum Nutr Diet, 2016, 29:549–575. [11] Rodino-Janeiro B K, Vicario M, Alonso-Cotoner C, et al. A review of microbiota and irritable bowel syndrome: future in therapies[J]. Adv Ther, 2018, 35：289–310. [12] Guo Q, Lin H, Chen P, et al. Dynamic changes of intestinal flora in patients with irritable bowel syndrome combined with anxiety and depression after oral administration of enterobacteria capsules[J]. Bioen-gineered, 2021, 12:11885–11897. [13] Mishima Y, Ishihara S.Molecular mechanisms of mic-robiota-mediated pathology in irritable bowel syndrome[J]. Int J Mol Sci, 2020, 21:8664. [14] Cao Y N, Feng L J, Liu Y Y, et al. Effect of Lactobacillus rhamnosus GG supernatant on serotonin transporter expression in rats with post-infectious irritable bowel syndrome[J]. World J Gastroenterol, 2018, 24:338–350. [15] Zhou C, Fang X, Xu J, et al. Bifidobacterium longum alleviates irritable bowel syndrome-related visceral hypersensitivity and microbiota dysbiosis via paneth cell regulation[J]. Gut Microbes, 2020, 12:1782156. [16] Staudacher H M, Ralph F S E, Irving P M, et al. Nutrient intake, diet quality, and diet diversity in irritable bowel syndrome and the impact of the low FODMAP diet[J]. J Acad Nutr Diet, 2020, 120:535–547. [17] Galica A N, Galica R, Dumitrascu D L.Diet, fibers, and probiotics for irritable bowel syndrome[J]. J Med Life, 2022, 15:174–179. [18] Dimidi E, Whelan K.Food supplements and diet as treatment options in irritable bowel syndrome[J]. Neurogastroenterol Motil, 2020, 32:e13951. [19] Mehtab W, Agarwal A, Singh N, et al. All that a physician should know about FODMAPs[J]. Indian J Gastroenterol, 2019, 38:378–390. [20] De Palma G, Shimbori C, Reed D E, et al. Histamine production by the gut microbiota induces visceral hyperalgesia through histamine 4 receptor signaling in mice[J]. Sci Transl Med, 2022, 14：eabj1895. [21] Singh P, Grabauskas G, Zhou S Y, et al. High FODMAP diet causes barrier loss via lipopolysaccharide-mediated mast cell activation[J]. JCI Insight, 2021, 6:e146529. [22] Altenbernd F, Schwarz L, Lipowicz B, et al. Myrrh and chamomile flower extract inhibit mediator release from IgE-stimulated mast-cell-like RBL-2H3 Cells[J]. Plants (Basel), 2022, 11:3422. [23] Russo F, Riezzo G, Orlando A, et al. A comparison of the low-FODMAPs diet and a tritordeum-based diet on the gastrointestinal symptom profile of patients suffering from irritable bowel syndrome-diarrhea variant (IBS-D): a randomized controlled trial[J]. Nutrients, 2022, 14:1544. [24] Wiffin M, Smith L, Antonio J, et al. Effect of a short-term low fermentable oligiosaccharide, disaccha- ride, monosaccharide and polyol (FODMAP) diet on exercise-related gastrointestinal symptoms[J]. J Int Soc Sports Nutr, 2019, 16:1. [25] So D, Loughman A, Staudacher H M.Effects of a low FODMAP diet on the colonic microbiome in irritable bowel syndrome: a systematic review with meta-analysis[J]. Am J Clin Nutr, 2022, 116:943–952. [26] Zhang Y, Feng L, Wang X, et al. Low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet compared with traditional dietary advice for diarrhea-predominant irritable bowel syndrome: a parallel-group, randomized controlled trial with analysis of clinical and microbiological factors associated with patient outcomes[J]. Am J Clin Nutr, 2021, 113:1531–1545. [27] Liu J, Chey W D, Haller E, et al. Low-FODMAP diet for irritable bowel syndrome: what we know and what we have yet to learn[J]. Annu Rev Med, 2020, 71:303–314. [28] Eswaran S, Dolan R D, Ball S C, et al. The impact of a 4-week low-FODMAP and mNICE diet on nutrient intake in a sample of US adults with irritable bowel syndrome with diarrhea[J]. J Acad Nutr Diet, 2020, 120:641–649. [29] So D, Yao C K, Ardalan Z S, ,et al. Supplementing dietary fibers with a low FODMAP diet in irritable bowel syndrome: a randomized controlled crossover trial[J]. Clin Gastroenterol Hepatol. Supplementing dietary fibers with a low FODMAP diet in irritable bowel syndrome: a randomized controlled crossover trial[J]. Clin Gastroenterol Hepatol, 2022, 20:2112–2120.e7. [30] Moayyedi P, Quigley E M, Lacy B E, et al. The effect of fiber supplementation on irritable bowel syndrome: a systematic review and meta-analysis[J]. Am J Gastroent-erol, 2014, 109:1367–1374. [31] Miller V, Lea R, Agrawal A, et al. Bran and irritable bowel syndrome: the primary-care perspective[J]. Dig Liver Dis, 2006, 38:737–740. [32] Barboi O B, Chirila I, Ciortescu I, et al. Inulin, choline and silymarin in the treatment of irritable bowel syndrome with constipation-randomized case-control study[J]. J Clin Med, 2022, 11:2248. [33] Micka A, Siepelmeyer A, Holz A, et al. Effect of consumption of chicory inulin on bowel function in healthy subjects with constipation: a randomized, double-blind, placebo-controlled trial[J]. Int J Food Sci Nutr, 2017, 68:82–89. [34] Gunn D, Abbas Z, Harris H C, et al. Psyllium reduces inulin-induced colonic gas production in IBS: MRI and in vitro fermentation studies[J]. Gut, 2022, 71:919–927. [35] Major G, Murray K, Singh G, et al. Demonstration of differences in colonic volumes, transit, chyme consistency, and response to psyllium between healthy and constipated subjects using magnetic resonance imaging[J]. Neurogastroenterol Motil, 2018, 30:e13400. [36] Yasukawa Z, Inoue R, Ozeki M, et al. Effect of repeated consumption of partially hydrolyzed guar gum on fecal characteristics and gut microbiota: a randomized, double-blind, placebo-controlled, and parallel-group clinical trial[J]. Nutrients, 2019, 11:2170. [37] Remes-Troche J M, Taboada-Liceaga H, Gill S,et al. Nopal fiber (Opuntia ficus-indica) improves symptoms in irritable bowel syndrome in the short term: a randomized controlled trial[J]. Neurogastroenterol Motil, 2021, 33:e13986. [38] Curro D. Current evidence on the therapeutic use of fiber in irritable bowel syndrome[J]. Expert Rev Gastroent-erol Hepatol, 2022, 16：425－436. [39] Yan R, Andrew L, Marlow E, et al. Dietary fibre intervention for gut microbiota, sleep, and mental health in adults with irritable bowel syndrome: a scoping review[J]. Nutrients, 2021, 13:2159. [40] Casseb G a S, Kaster M P, Rodrigues A L S. Potential role of vitamin D for the management of depression and anxiety[J]. CNS Drugs, 2019, 33:619–637. [41] Mogire R M, Mutua A, Kimita W, et al. Prevalence of vitamin D deficiency in Africa: a systematic review and meta-analysis[J]. Lancet Glob Health, 2020, 8:e134–e142. [42] Khayyat Y, Attar S.Vitamin D deficiency in patients with irritable bowel syndrome: does it exist?[J]. Oman Med J, 2015, 30:115–118. [43] Chong R I H, Yaow C Y L, Loh C Y L, et al. Vitamin D supplementation for irritable bowel syndrome: A systematic review and meta-analysis[J]. J Gastroenterol Hepatol, 2022, 37：993–1003. [44] Sprake E F, Grant V A, Corfe B M. Vitamin D3 as a novel treatment for irritable bowel syndrome: single case leads to critical analysis of patient-centred data[J]. BMJ Case Rep, 2012, 2012:bcr-2012–007223. [45] Khalighi Sikaroudi M, Mokhtare M, Janani L, et al. Vitamin D3 supplementation in diarrhea-predominant irritable bowel syndrome patients: the effects on symptoms improvement, serum corticotropin-releasing hormone, and interleukin-6 - a randomized clinical trial[J]. Complement Med Res, 2020, 27:302–309. [46] Jalili M, Vahedi H, Poustchi H, et al. Effects of vitamin D supplementation in patients with irritable bowel syndrome: a randomized, double-blind, placebo-controlled clinical trial[J]. Int J Prev Med, 2019, 10:16. [47] Alvi H, Ali G, Iqbal S, et al. Role of 25-hydroxyvitamin D in irritable bowel syndrome patients[J]. J Family Med Prim Care, 2022, 11:7975–7978. [48] Fakhoury H M A, Kvietys P R, Alkattan W, et al. Vitamin D and intestinal homeostasis: barrier, microbiota, and immune modulation[J]. J Steroid Biochem Mol Biol, 2020, 200：105663. [49] Camilleri M, Lasch K, Zhou W.Irritable bowel syndrome: methods, mechanisms, and pathophysiology. The conf-luence of increased permeability, inflammation, and pain in irritable bowel syndrome[J]. Am J Physiol Gastrointest Liver Physiol, 2012, 303:G775–785. [50] Patrick RP, Ames BN.Vitamin D hormone regulates serotonin synthesis. Part 1: relevance for autism[J]. FASEB J, 2014, 28:2398–2413. [51] Abbasnezhad A, Amani R, Hajiani E, et al. Effect of vitamin D on gastrointestinal symptoms and health- related quality of life in irritable bowel syndrome patients: a randomized double-blind clinical trial[J]. Neurogastroenterol Motil, 2016, 28:1533–1544. [52] El Amrousy D, Hassan S, El Ashry H, et al. Vitamin D supplementation in adolescents with irritable bowel syndrome: Is it useful? A randomized controlled trial[J]. Saudi J Gastroenterol, 2018, 24:109–114. [53] Wen Y, Jiang M Z.Role of vitamin D in pediatric irritable bowel syndrome[J]. Zhongguo Dang Dai Er Ke Za Zhi, 2021, 23:310–314. [54] Michalak A, Mosinska P, Fichna J.Polyunsaturated fatty acids and their derivatives: therapeutic value for inflammatory, functional gastrointestinal disorders, and colorectal cancer[J]. Front Pharmacol, 2016, 7:459. [55] Goldberg R J, Katz J.A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain[J]. Pain, 2007, 129:210–223. [56] Meister D, Ghosh S.Effect of fish oil enriched enteral diet on inflammatory bowel disease tissues in organ culture: differential effects on ulcerative colitis and Crohn's disease[J]. World J Gastroenterol, 2005, 11:7466–7472. [57] Sanders A E, Weatherspoon E D, Ehrmann B M, et al. Ratio of Omega-6/Omega-3 polyunsaturated fatty acids associated with somatic and depressive symptoms in people with painful temporomandibular disorder and irritable bowel syndrome[J]. J Pain, 2022, 23:1737–1748. [58] Liu Y, Chen F, Odle J, et al. Fish oil enhances intestinal integrity and inhibits TLR4 and NOD2 signaling pathways in weaned pigs after LPS challenge[J]. J Nutr, 2012, 142:2017–2024. [59] Arita M, Yoshida M, Hong S, et al. Resolvin E1, an endogenous lipid mediator derived from omega-3 eicosapentaenoic acid, protects against 2,4,6- trini-trobenzene sulfonic acid-induced colitis[J]. Proc Natl Acad Sci U S A, 2005, 102:7671–7676. [60] Feng R, Ma L J, Wang M, et al. Oxidation of fish oil exacerbates alcoholic liver disease by enhancing intestinal dysbiosis in mice[J]. Commun Biol, 2020, 3:481. [61] Clarke G, Fitzgerald P, Hennessy A A, et al. Marked elevations in pro-inflammatory polyunsaturated fatty acid metabolites in females with irritable bowel syndrome[J]. J Lipid Res, 2010, 51:1186–1192. [62] Cenac N, Bautzova T, Le Faouder P, ,et al. Quantification. Quantification and potential functions of endogenous agonists of transient receptor potential channels in patients with irritable bowel syndrome[J]. Gastroenterology, 2015, 149:433–444.e7. [63] Serra J L, Rodrigues A, De Freitas R A, et al. Alternative sources of oils and fats from Amazonian plants: fatty acids, methyl tocols, total carotenoids and chemical composition[J]. Food Res Int, 2019, 116:12–19. [64] Saini R K, Keum Y S.Omega-3 and omega-6 polyunsaturated fatty acids: dietary sources, metabolism, and significance - a review[J]. Life Sci, 2018, 203:255-267. [65] Choque B, Catheline D, Rioux V, et al. Linoleic acid: between doubts and certainties[J]. Biochimie, 2014, 96:14–21. [66] Erdinest N, Shmueli O, Grossman Y, et al. Anti-inflam-matory effects of alpha linolenic acid on human corneal epithelial cells[J]. Invest Ophthalmol Vis Sci, 2012, 53:4396–4406. [67] Stenlund H, Nilholm C, Chorell E, et al. Metabolic profiling of plasma in patients with irritable bowel syndrome after a 4-week starch-and sucrose-reduced diet[J]. Metabolites, 2021, 11:440. [68] Lee S E, Lim J W, Kim J M, et al. Anti-inflammatory mechanism of polyunsaturated fatty acids in helico- bacter pylori-infected gastric epithelial cells[J]. Mediators Inflamm, 2014, 2014:128919. [69] Chen P Y, Wang J, Lin Y C, et al. 18-carbon polyun-saturated fatty acids ameliorate palmitate-induced inflammation and insulin resistance in mouse C2C12 myotubes[J]. J Nutr Biochem, 2015, 26:521–531. [70] IBD in EPIC study Investigators, Tjonneland A, Overvad K, et al. Linoleic acid, a dietary n-6 polyunsaturated fatty acid, and the aetiology of ulcerative colitis: a nested case-control study within a European prospective cohort study[J]. Gut, 2009, 58:1606–1611.
