小腸内菌増殖症を伴う過敏性腸症候群では、糖質制限食を選択すべきか

 

Office Uno Column; Yoshiharu Uno

 

If the IBS patients have SIBO (small bowel bacterial overgrowth), it will be the small intestinal fermentation by sugars (glucose and...) without high FODMAPs. 
  
もし、過敏性腸行群に小腸内菌増殖症を伴っている場合では、高フォドマップ食以外の糖質（ブドウ糖など）によって小腸内発酵が起こる。
 

Global carbohydrate diet (including high-FODMAPs) is need for improvement of symptoms of IBS with SIBO.
このような状態では、高フォドマップを含め炭水化物全体を制限（糖質制限）する必要がある。

 

Another method may be a combination therapy of eradication and low-FODMAP.
他の方法としては、小腸内の菌の除菌療法と低フォドマップ食を併用する方法が有効であろう。

SIBO

As a prerequisite, the most important is the diagnostic method of reliable SIBO.

Namely, reliable diagnosis of SIBO is essential to effective diet.
この仮説の中で重要なことは、小腸内菌増殖症の確実な診断である。
現在の呼気テストによる診断法よりも確かな診断法が望まれる。

In lactulose hydrogen breath test it is possible to know the increase of bacteria.
However, after ingestion of lactulose, how much gas in the small intestine is increased remain unknown.
It might be inaccurate earthquake forecast or weather forecast.

 ラクツロース水素呼気テストでは、細菌の増加を知ることができます。
しかし、ラクツロースの摂取後に、小腸にガスが増加しているかは検証されていない。
もしかしたら、これは、不正確な地震予報や天気予報かもしれません。

 

Please look forward to the publication of my research results.


 



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<Refference>
 

Gastroenterol Hepatol. 2015 Nov 5. pii: S0210-5705(15)00221-6. doi: 10.1016/j.gastrohep.2015.07.009. [Epub ahead of print]

The low-FODMAP diet for irritable bowel syndrome: Lights and shadows.

Molina-Infante J1, Serra J2, Fernandez-Bañares F3, Mearin F4.

 

·         1Department of Gastroenterology, Hospital San Pedro de Alcantara, Caceres, Spain. Electronic address: xavi_molina@hotmail.com.

·         2Motility and Functional Gut Disorders Unit, University Hospital Germans Trias I Pujol, Autonomous University of Barcelona, Badalona, Spain; CIBERehd, Spain.

·         3CIBERehd, Spain; Department of Gastroenterology, Hospital Universitari Mutua Terrassa, Spain.

·         4Department of Gastroenterology, Centro Médico Teknon, Barcelona, Spain.

Abstract

Irritable bowel syndrome (IBS) affects 10-15% of the western population. Drug therapy for this entity has shown limited efficacy. The low Fermentable Oligo-, Di-, Monosaccharides And Polyols (FODMAP) diet has recently emerged as an effective intervention for reducing gastrointestinal symptoms in IBS. Currently, several mechanistic studies have proven the rational basis of carbohydrate restriction. In addition, high-quality evidence (prospective studies and randomized controlled trials) from a variety of countries supports the high effectiveness of a low-FODMAP diet for IBS symptoms (70%), especially abdominal bloating, pain, and diarrhea. Importantly, this diet seems to be superior to a gluten-free diet for patients with non-celiac gluten sensitivity. The most controversial features of the low FODMAP diet are its short- and long-term limitations (a high level of restriction, the need for monitoring by an expert dietitian, potential nutritional deficiencies, significant gut microbiota reduction, lack of predictors of response), as well as the potential lack of advantage over alternative dietary, pharmacological and psychological interventions for IBS. Although liberalization of carbohydrate intake is recommended in the long-term, the reintroduction process remains to be clarified as, theoretically, global carbohydrate restriction is deemed to be necessary to avoid additive effects.