デンマーク発表：低FODMAP食は軽度～中等度の活動期の炎症性腸疾患の症状を改善する

Y Uno

これまでも、低FODMAP食が過敏性腸症候群（IBS）だけではなく、炎症性腸疾患（IBD:潰瘍性大腸炎やクローン病）の症状を改善するという報告があったが、今回のデンマークの報告は、多施設の前向きのランダム比較研究である。

この研究で特徴的なのは、寛解期だけではなく、炎症のある軽度から中等度の活動期を含めたことである。

そして、低FODMAP食を6週間摂取した後、潰瘍性大腸炎やクローン病の症状の改善が通常食よりも有意に改善しただけではなく、潰瘍性大腸炎では単純臨床大腸炎指数（SCCAI）も軽快した。

https://www.ncbi.nlm.nih.gov/pubmed/28566897

World J Gastroenterol. 2017 May 14;23(18):3356-3366. doi: 10.3748/wjg.v23.i18.3356.

Low-FODMAP diet reduces irritable bowel symptoms in patients with inflammatory bowel disease.

Pedersen N¹, Ankersen DV¹, Felding M¹, Wachmann H¹, Végh Z¹, Molzen L¹, Burisch J¹, Andersen JR¹, Munkholm P¹.

1　Natalia Pedersen, Department of Gastroenterology, Slagelse Hospital, 4200 Slagelse, Denmark.

Abstract

AIM:

To investigate the effect of a low-FODMAP diet on irritable bowel syndrome (IBS)-like symptoms in patients with inflammatory bowel disease (IBD).

METHODS:

This was a randomised controlled open-label trial of patients with IBD in remission or with mild-to-moderate disease and coexisting IBS-like symptoms (Rome III) randomly assigned to a Low-FODMAP diet (LFD) or a normal diet (ND) for 6 wk between June 2012 and December 2013. Patients completed the IBS symptom severity system (IBS-SSS) and short IBD quality of life questionnaire (SIBDQ) at weeks 0 and 6. The primary end-point was response rates (at least 50-point reduction) in IBS-SSS at week 6 between groups; secondary end-point was the impact on quality of life.

RESULTS:

Eighty-nine patients, 67 (75%) women, median age 40, range 20-70 years were randomised: 44 to LFD group and 45 to ND, from which 78 patients completed the study period and were included in the final analysis (37 LFD and 41 ND). There was a significantly larger proportion of responders in the LFD group (n = 30, 81%) than in the ND group (n = 19, 46%); (OR = 5.30; 95%CI: 1.81-15.55, P < 0.01). At week 6, the LFD group showed a significantly lower median IBS-SSS (median 115; inter-quartile range [IQR] 33-169) than ND group (median 170, IQR 91-288), P = 0.02. Furthermore, the LFD group had a significantly greater increase in SIBDQ (median 60, IQR 51-65) than the ND group (median 50, IQR 39-60), P < 0.01.

CONCLUSION:

In a prospective study, a low-FODMAP diet reduced IBS-like symptoms and increased quality of life in patients with IBD in remission.