PDF(Pubmed)
Abstract：
Most adverse reactions to food are patient self-reported and not based on validated tests but nevertheless lead to dietary restrictions, with patients believing that these restrictions will improve their symptoms and quality of life. We aimed to clarify the myths and reality of common food intolerances, giving clinicians a guide on diagnosing and treating these cases. We performed a narrative review of the latest evidence on the widespread food intolerances reported by our patients, giving indications on the clinical presentations, possible tests, and dietary suggestions, and underlining the myths and reality. While lactose intolerance and hereditary fructose intolerance are based on well-defined mechanisms and have validated diagnostic tests, non-coeliac gluten sensitivity and fermentable oligosaccharide, disaccharide, monosaccharide, and polyol (FODMAP) intolerance are mainly based on patients\' reports. Others, like non-hereditary fructose, sorbitol, and histamine intolerance, still need more evidence and often cause unnecessary dietary restrictions. Finally, the main outcome of the present review is that the medical community should work to reduce the spread of unvalidated tests, the leading cause of the problematic management of our patients.
摘要：
大多数食物不良反应是患者自我报告的，不是基于经过验证的测试，但仍然会导致饮食限制。患者认为这些限制会改善他们的症状和生活质量。我们旨在澄清常见食物不耐受的神话和现实，为临床医生提供诊断和治疗这些病例的指导。我们对患者报告的广泛食物不耐受的最新证据进行了叙述性审查，给出临床表现的适应症，可能的测试，和饮食建议，强调神话和现实。虽然乳糖不耐受和遗传性果糖不耐受是基于明确的机制，并已验证诊断测试，非乳糜泻谷蛋白敏感性和可发酵寡糖，二糖，单糖，和多元醇（FODMAP）不耐受主要基于患者报告。Others,比如非遗传性果糖，山梨醇,和组胺不耐受,仍然需要更多的证据，并经常导致不必要的饮食限制。最后,本次审查的主要结果是，医学界应努力减少未经验证的测试的传播，我们病人管理有问题的主要原因。
